Provider Demographics
NPI:1962363226
Name:BURNETT, JESSICA (MPS, LPC-A, ATR-P)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:BURNETT
Suffix:
Gender:F
Credentials:MPS, LPC-A, ATR-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3112 WINDSOR RD # 326
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78703-2350
Mailing Address - Country:US
Mailing Address - Phone:512-230-9648
Mailing Address - Fax:
Practice Address - Street 1:1301 S CAPITAL OF TEXAS HWY STE C130
Practice Address - Street 2:
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-6590
Practice Address - Country:US
Practice Address - Phone:512-309-1950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-18
Last Update Date:2025-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25-511221700000X
TX100049101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist