Provider Demographics
NPI:1932627718
Name:BURD, ALAN EDWARD (MA, MED, LPCC001626)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:EDWARD
Last Name:BURD
Suffix:
Gender:M
Credentials:MA, MED, LPCC001626
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 BROWN AVE
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-1802
Mailing Address - Country:US
Mailing Address - Phone:936-524-0962
Mailing Address - Fax:
Practice Address - Street 1:333 W DRAKE RD
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-6320
Practice Address - Country:US
Practice Address - Phone:970-218-3381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-31
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONLC.0107157101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health