Provider Demographics
NPI:1184950966
Name:BURR, ELIZABETH A (LPCC)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:A
Last Name:BURR
Suffix:
Gender:F
Credentials:LPCC
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 94
Mailing Address - Street 2:
Mailing Address - City:DEMING
Mailing Address - State:NM
Mailing Address - Zip Code:88031-0094
Mailing Address - Country:US
Mailing Address - Phone:575-546-5574
Mailing Address - Fax:
Practice Address - Street 1:5545 DONA ANA RD SE
Practice Address - Street 2:
Practice Address - City:DEMING
Practice Address - State:NM
Practice Address - Zip Code:88030-8447
Practice Address - Country:US
Practice Address - Phone:575-546-5574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-28
Last Update Date:2009-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0059101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM0059Other0059 LPCC, STATE OF NEW MEXICO