Individual
NICHOLAS BURNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC-IT, SAC-IT
Contact information
Practice address
3240 JACKSON ST, OSHKOSH, WI 54901-1208
(920) 231-0143
Mailing address
3240 JACKSON ST, OSHKOSH, WI 54901-1208
(920) 231-0143
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
20615-130
WI
101YP2500X
Professional Counselor
Primary
7912-226
WI
Other
Enumeration date
07/12/2024
Last updated
07/18/2024
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