Provider Demographics
NPI:1427420637
Name:BURTON, BRIAN GENTRY (LPC, LMFT)
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:GENTRY
Last Name:BURTON
Suffix:
Gender:M
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1672 SOUTH 48TH STREET
Mailing Address - Street 2:SUITE B
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72762
Mailing Address - Country:US
Mailing Address - Phone:479-202-6300
Mailing Address - Fax:479-202-6300
Practice Address - Street 1:1672 SOUTH 48TH STREET
Practice Address - Street 2:SUITE B
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762
Practice Address - Country:US
Practice Address - Phone:479-202-6300
Practice Address - Fax:479-202-6300
Is Sole Proprietor?:No
Enumeration Date:2015-10-27
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
ARP1809119101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor