Provider Demographics
NPI:1821371964
Name:BURLEY, MICHELE (MA, NCC)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:BURLEY
Suffix:
Gender:F
Credentials:MA, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 88275
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80908-8275
Mailing Address - Country:US
Mailing Address - Phone:719-332-6394
Mailing Address - Fax:
Practice Address - Street 1:4585 HILTON PKWY
Practice Address - Street 2:SUITE 202
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-3569
Practice Address - Country:US
Practice Address - Phone:888-600-1088
Practice Address - Fax:719-599-4693
Is Sole Proprietor?:No
Enumeration Date:2011-09-26
Last Update Date:2013-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health