Healthcare Provider Details

I. General information

NPI: 1710519731
Provider Name (Legal Business Name): BRENDA SUE BURGARD LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2020
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7136 BELLROSE AVE NE
ALBUQUERQUE NM
87110-1451
US

IV. Provider business mailing address

7136 BELLROSE AVE NE
ALBUQUERQUE NM
87110-1451
US

V. Phone/Fax

Practice location:
  • Phone: 505-872-9480
  • Fax:
Mailing address:
  • Phone: 505-872-9480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCBT-2024-0729
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: