Healthcare Provider Details

I. General information

NPI: 1114839792
Provider Name (Legal Business Name): BRITTANY ANNABELLE BURDOCK LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2026
Last Update Date: 09/19/2026
Certification Date: 09/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 EUBANK BLVD NE STE 1
ALBUQUERQUE NM
87112-5300
US

IV. Provider business mailing address

1201 EUBANK BLVD NE STE 1
ALBUQUERQUE NM
87112-5300
US

V. Phone/Fax

Practice location:
  • Phone: 505-361-1957
  • Fax: 505-369-1851
Mailing address:
  • Phone: 505-361-1957
  • Fax: 505-369-1851

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCTB-2026-0818
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: