Provider Demographics
NPI:1174900534
Name:BURNETT, ANTOINETTE (LMHC)
Entity type:Individual
Prefix:
First Name:ANTOINETTE
Middle Name:
Last Name:BURNETT
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 S FRANKLIN AVE STE 1541
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-6108
Mailing Address - Country:US
Mailing Address - Phone:516-849-4947
Mailing Address - Fax:
Practice Address - Street 1:111 S FRANKLIN AVENUE
Practice Address - Street 2:SUITE 1541
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-6108
Practice Address - Country:US
Practice Address - Phone:516-849-4947
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-05
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor