Kaitlin Burke, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

25456 Issued in MN

Practice address

4016 Willow Rd N
Brooklyn Park, MN 55443-1240

Phone

(763) 639-7474

NPI assigned

Oct 21, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Anoka Metro Regional Treatment Center

  • Psychiatric Hospital
  • Anoka, MN
  • NPI 1275585564

  MN

  Medicare reassignment NPD
• Burke Therapeutics, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Brooklyn Park, MN
  • NPI 1093573768
  NPD Authorized official
• Riverbend Counseling L.L.C.

  • Clinical Social Worker
  • Minneapolis, MN
  • NPI 1992157663

  Clinical

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1603238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1003415969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4016 WILLOW RD N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554431240",
            "telephone_number": "763-639-7474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4016 WILLOW RD N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554431240",
            "telephone_number": "763-639-7474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKE",
        "first_name": "KAITLIN",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-21",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "25456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Moraya Buenano, CHW
• Amy Buggert, RN
• James R. Bukstein, M.D.
• Suhair H Burhan, MD
• Burke Therapeutics, LLC
• Stephanie Marie Burrow, LPCC
• Patricia Ann Bury, RN
• James G B Buss, MD
• Callina Healthcare Services, LLC
• Christina N Cao, PHARM.D.

• All providers in Brooklyn Park, MN
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.