Healthcare Provider Details

I. General information

NPI: 1407765035
Provider Name (Legal Business Name): LUCIA BURSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11290 W ALAMEDA AVE STE 160
LAKEWOOD CO
80226-2510
US

IV. Provider business mailing address

11290 W ALAMEDA AVE
LAKEWOOD CO
80226-2576
US

V. Phone/Fax

Practice location:
  • Phone: 303-691-6095
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number.0025317
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: