Provider Demographics
NPI:1770228561
Name:BURNETT, ALYSSABETH (INTERN)
Entity Type:Individual
Prefix:
First Name:ALYSSABETH
Middle Name:
Last Name:BURNETT
Suffix:
Gender:F
Credentials:INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5797 S KING ST APT 6
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-2864
Mailing Address - Country:US
Mailing Address - Phone:303-513-9925
Mailing Address - Fax:
Practice Address - Street 1:1800 W LITTLETON BLVD
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-2021
Practice Address - Country:US
Practice Address - Phone:720-806-0069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-05
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COADDC.0000281101YA0400X
COLPCC.0020101101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)