Provider Demographics
NPI:1366471799
Name:BURRELL, AILEEN CALLAHAN (LCSW)
Entity Type:Individual
Prefix:
First Name:AILEEN
Middle Name:CALLAHAN
Last Name:BURRELL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:AILEEN
Other - Middle Name:LYNN
Other - Last Name:CALLAHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:8000 E PRENTICE AVE
Mailing Address - Street 2:B-13
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2744
Mailing Address - Country:US
Mailing Address - Phone:720-339-8038
Mailing Address - Fax:
Practice Address - Street 1:444 W FORT ST. FL 2
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702-4535
Practice Address - Country:US
Practice Address - Phone:208-422-1018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9929291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical