Provider Demographics
NPI:1336577246
Name:BURDICK, LINDA LEE (EDS, NCSP, LPC)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:LEE
Last Name:BURDICK
Suffix:
Gender:F
Credentials:EDS, NCSP, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8420 S SANGRE DE CRISTO RD
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127
Mailing Address - Country:US
Mailing Address - Phone:303-972-7433
Mailing Address - Fax:
Practice Address - Street 1:8420 SANGRE DE CRISTO RD
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-4201
Practice Address - Country:US
Practice Address - Phone:970-712-2542
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-31
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO124311103TS0200X
COLPC.0012917101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO29267501Medicaid