MEDICARE: CHRISTINA BURG M.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1518364280
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA BURG M.A.

Provider Business Mailing Address
First Line	:	664 S LINCOLN ST APT 301
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80209-4046
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1805 S BELLAIRE ST STE 2151
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80222-4305
Country	:	US
Telephone Number	:	720-588-0698
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/24/2014
Last Update Date	:	03/17/2018

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