Basic Information
| Provider Information | |||||||||
| NPI: | 1568744142 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BURNS | ||||||||
| FirstName: | SHAWNA | ||||||||
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| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 317 W INDUSTRIAL PARK RD | ||||||||
| Address2: | |||||||||
| City: | HARRISON | ||||||||
| State: | AR | ||||||||
| PostalCode: | 726016804 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8707412960 | ||||||||
| FaxNumber: | 8707412965 | ||||||||
| Practice Location | |||||||||
| Address1: | 1003 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | HARRISON | ||||||||
| State: | AR | ||||||||
| PostalCode: | 726012517 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8702046016 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/09/2011 | ||||||||
| LastUpdateDate: | 04/13/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/13/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | P0809069 | AR | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.