Provider Demographics
NPI:1396352209
Name:BURNETT, JAMES CALEB (MS, BCBA)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:CALEB
Last Name:BURNETT
Suffix:
Gender:M
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2360 MURPHY BLVD
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30504-6002
Mailing Address - Country:US
Mailing Address - Phone:770-535-8372
Mailing Address - Fax:770-535-0252
Practice Address - Street 1:2360 MURPHY BLVD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30504-6002
Practice Address - Country:US
Practice Address - Phone:770-535-8372
Practice Address - Fax:770-535-0252
Is Sole Proprietor?:No
Enumeration Date:2020-09-24
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARBT-20-126918106S00000X
GA1-22-62962103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician