Provider Demographics
NPI:1558673459
Name:BURT, JEFFREY DAVID (LPC, LAC)
Entity type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:DAVID
Last Name:BURT
Suffix:
Gender:M
Credentials:LPC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5850 CENTRAL AVE UNIT 327
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-2979
Mailing Address - Country:US
Mailing Address - Phone:720-636-5922
Mailing Address - Fax:
Practice Address - Street 1:5850 CENTRAL AVE UNIT 327
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-2979
Practice Address - Country:US
Practice Address - Phone:720-636-5922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-08
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180007370101Y00000X
CO5795101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor