Provider Demographics
NPI:1124499454
Name:BURNHAM, DORINDA L (LMHC)
Entity type:Individual
Prefix:
First Name:DORINDA
Middle Name:L
Last Name:BURNHAM
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 1:6817 SOUTHPOINT PKWY STE 1904
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-6299
Mailing Address - Country:US
Mailing Address - Phone:042-807-3009
Mailing Address - Fax:904-212-2729
Practice Address - Street 1:6817 SOUTHPOINT PKWY STE 1904
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-6299
Practice Address - Country:US
Practice Address - Phone:904-280-7300
Practice Address - Fax:904-212-2729
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-13
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health