Provider Demographics
NPI:1053616805
Name:BURNS, ERIC RUSSELL (EDD, ACD, LPC)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:RUSSELL
Last Name:BURNS
Suffix:
Gender:
Credentials:EDD, ACD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 SULLIVAN ST
Mailing Address - Street 2:
Mailing Address - City:BAILEY
Mailing Address - State:CO
Mailing Address - Zip Code:80421-1583
Mailing Address - Country:US
Mailing Address - Phone:720-231-9675
Mailing Address - Fax:
Practice Address - Street 1:224 SULLIVAN ST
Practice Address - Street 2:
Practice Address - City:BAILEY
Practice Address - State:CO
Practice Address - Zip Code:80421-1583
Practice Address - Country:US
Practice Address - Phone:720-231-9675
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-25
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0015304101YM0800X
101YM0800X
CO0001867101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)