Jason Maurice Burnett, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149021328 Issued in IL

Practice address

1029 Des Plaines Ave Apt 404
Forest Park, IL 60130-2146

Phone

(312) 342-7504

NPI assigned

Aug 13, 2019

Last updated

Aug 13, 2019By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1565654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565654400000",
    "number": "1033765326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1029 DES PLAINES AVE APT 404",
            "city": "FOREST PARK",
            "state": "IL",
            "postal_code": "601302146",
            "telephone_number": "312-342-7504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1029 DES PLAINES AVE APT 404",
            "city": "FOREST PARK",
            "state": "IL",
            "postal_code": "601302146",
            "telephone_number": "312-342-7504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNETT",
        "first_name": "JASON",
        "middle_name": "MAURICE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-13",
        "last_updated": "2019-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149021328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Forest Park, IL
• Providers in Forest Park, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.