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Individual

SHANIQUA CELESS BURNETTE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS,LCMHC, LCASA, NCC

Contact information

Practice address
3705 LATROBE DR STE 340, CHARLOTTE, NC 28211-4823
(704) 364-3989
Mailing address
3705 LATROBE DR STE 340, CHARLOTTE, NC 28211-4823
(704) 364-3989

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCASA25077
NC
101YM0800X
Mental Health Counselor
A14443
NC
101YP2500X
Professional Counselor
Primary
14443
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1265540884
NC
Enumeration date
11/28/2018
Last updated
05/08/2023
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