Active NPI
Justin Burgess, CSW
- Clinical Social Worker
- Rawlins, WY
National Provider Identifier
1013377233
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CSW-252
- Practice address
- 721 W Maple St
Rawlins, WY 82301-5447 - Phone
- (307) 324-7156
- Fax
- (307) 328-1651
- NPI assigned
- Mar 1, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CSW-252 | WY | Primary |
Addresses
Primary practice location
721 W Maple St
Rawlins, WY 82301-5447
Mailing address
721 W Maple St
Rawlins, WY 82301-5447
Phone (307) 324-7156
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CSW-252 | WY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1456790400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1463529600000",
"number": "1013377233",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "721 W MAPLE ST",
"city": "RAWLINS",
"state": "WY",
"postal_code": "823015447",
"telephone_number": "307-324-7156",
"fax_number": "307-328-1651"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "721 W MAPLE ST",
"city": "RAWLINS",
"state": "WY",
"postal_code": "823015447",
"telephone_number": "307-324-7156",
"fax_number": "307-328-1651"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURGESS",
"first_name": "JUSTIN",
"credential": "CSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-03-01",
"last_updated": "2016-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WY",
"license": "CSW-252",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rawlins, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.