Provider Demographics
NPI:1518671247
Name:BURRUSS, ANNE COOK (ALC, NBCC)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:COOK
Last Name:BURRUSS
Suffix:
Gender:F
Credentials:ALC, NBCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3713 BRIAR OAK CIR
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN BRK
Mailing Address - State:AL
Mailing Address - Zip Code:35223-2826
Mailing Address - Country:US
Mailing Address - Phone:901-361-8449
Mailing Address - Fax:
Practice Address - Street 1:200 CAHABA PARK CIR STE 214
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-8113
Practice Address - Country:US
Practice Address - Phone:205-903-6282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALC3472A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health