Provider Demographics
NPI:1588982029
Name:STRUCTURED LEARNING ASPECTS, INC
Entity type:Organization
Organization Name:STRUCTURED LEARNING ASPECTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KEELEE
Authorized Official - Middle Name:KATHLEEN
Authorized Official - Last Name:BURTCH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:720-470-0578
Mailing Address - Street 1:2101 MARKET ST APT 328
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-2097
Mailing Address - Country:US
Mailing Address - Phone:720-470-0578
Mailing Address - Fax:
Practice Address - Street 1:2101 MARKET ST APT 328
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-2097
Practice Address - Country:US
Practice Address - Phone:720-470-0578
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-07
Last Update Date:2010-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0389660103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO19100078Medicaid
CO77634772Medicaid