Healthcare Provider Details

I. General information

NPI: 1972002293
Provider Name (Legal Business Name): KRISTIN BURDGE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2018
Last Update Date: 05/22/2025
Certification Date: 05/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

407 S LINCOLN AVE
STEAMBOAT SPRINGS CO
80487-8934
US

IV. Provider business mailing address

1829 SUMMIT PL NW APT 303
WASHINGTON DC
20009-2328
US

V. Phone/Fax

Practice location:
  • Phone: 970-879-2141
  • Fax: 970-879-7912
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904010243
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: