Burnett, Connie

Burnett, Connie is an sole proprietor health care provider with primary practice located at 375 Park Ave , Coos Bay OR 97420-2244. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Burnett, Connie can be contacted via phone (406) 925-1313.

Contact Information

Primary practice address
375 Park Ave Coos Bay OR 97420-2244
Phone: (406) 925-1313
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 1158 Montana
Behavioral Health & Social Service Providers / Professional 101YP2500X C4806 Oregon

Profile Details

NPI number 1154487882
LBN Legal business name Burnett, Connie
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 28th, 2006
Last updated Jul 30th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154487882 NPPES
Montana Other 000741910 BLUE CROSS BLUE SHIELD
Montana MEDICAID 256542 BLUE CROSS BLUE SHIELD
Montana MEDICAID 0255374 BLUE CROSS BLUE SHIELD

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