Burgess, Virginia Lee
Burgess, Virginia Lee is an individual health care provider with primary practice located at 1001 W Broadway Ste D Behavioral Health Dept., Farmington NM 87401-5638. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Burgess, Virginia Lee can be contacted via phone (505) 566-0317.Contact Information
Primary practice address
1001 W Broadway Ste D Behavioral Health Dept.
Farmington NM 87401-5638
Phone: (505) 566-0317
Fax: (505) 327-7247
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | I-06004 | New Mexico |
Profile Details
| NPI number | 1457339764 |
|---|---|
| LBN Legal business name | Burgess, Virginia Lee |
| Credentials | LISW |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 6th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1457339764 | NPPES |
| New Mexico | MEDICAID | K5222 | |
| New Mexico | Other | 644452 |
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