MEDICARE: MS. STARNISHA BURNETTE QPMH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	175T00000X	Peer Specialist
2	101Y00000X	Counselor		NC

General Provider Information

NPI Number	:	1568923142
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. STARNISHA BURNETTE QPMH

Provider Business Mailing Address
First Line	:	PO BOX 359
Second Line	:
City	:	MORRISVILLE
State	:	NC
Zip	:	27560-0359
Country	:	US
Telephone Number	:	919-998-8487
Fax Number	:

Provider Business Practice Location Address
First Line	:	106 KNIGHTWOOD DR
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27703-6338
Country	:	US
Telephone Number	:	336-484-1052
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2019
Last Update Date	:	11/30/2025

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