Provider Demographics
NPI:1780675769
Name:BURR, PATRICIA M (MA, LPCC, NCC)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:M
Last Name:BURR
Suffix:
Gender:F
Credentials:MA, LPCC, NCC
Other - Prefix:MS
Other - First Name:PATRICIA
Other - Middle Name:
Other - Last Name:MARTINEZ BURR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, LPCC, NCC
Mailing Address - Street 1:6501 4TH ST NW
Mailing Address - Street 2:STE F
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87107-5800
Mailing Address - Country:US
Mailing Address - Phone:505-247-0366
Mailing Address - Fax:505-247-0376
Practice Address - Street 1:6501 4TH ST NW
Practice Address - Street 2:STE F
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-5800
Practice Address - Country:US
Practice Address - Phone:505-247-0366
Practice Address - Fax:505-247-0376
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2191101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor