# MS. JACQUETTA BURNSIDE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1699423301
- **Gender:** F

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | LGPC200001269 | DC | Yes |
| 101YP2500X | Professional Counselor | LGPC200001269 | DC | — |
| 103K00000X | Behavior Analyst | — | NULL | — |

## Other

- **Enumeration date:** 03/11/2022
- **Last updated:** 04/25/2026