MEDICARE: BRENDA SUE BURGARD LPCC

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	101YP2500X	Professional Counselor	CBT-2024-0729	NM
2	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1710519731
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENDA SUE BURGARD LPCC

Provider Business Mailing Address
First Line	:	7136 BELLROSE AVE NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87110-1451
Country	:	US
Telephone Number	:	505-872-9480
Fax Number	:

Provider Business Practice Location Address
First Line	:	7136 BELLROSE AVE NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87110-1451
Country	:	US
Telephone Number	:	505-872-9480
Fax Number	:

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

Provider Enumeration Date	:	02/07/2020
Last Update Date	:	06/24/2026

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