Provider Demographics
NPI:1467888057
Name:BURRIS, JULIA (LMSW)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:BURRIS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 STEPHEN MOODY ST SE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87123-1992
Mailing Address - Country:US
Mailing Address - Phone:505-235-5888
Mailing Address - Fax:
Practice Address - Street 1:701 STEPHEN MOODY ST SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87123-1992
Practice Address - Country:US
Practice Address - Phone:505-235-5888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-16
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist