Provider Demographics
NPI:1932503729
Name:BURGIN, ELIZABETH (BPS, MA CANDIDATE)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:BURGIN
Suffix:
Gender:F
Credentials:BPS, MA CANDIDATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6285 LEHMAN DR STE 101
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-1497
Mailing Address - Country:US
Mailing Address - Phone:719-227-7477
Mailing Address - Fax:
Practice Address - Street 1:6285 LEHMAN DR STE 101
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-1497
Practice Address - Country:US
Practice Address - Phone:719-227-7477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-22
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health