Mayra Santiago-Burgos, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

004689 Issued in CT

Practice address

500 Vine St
Hartford, CT 06112-1639

Phone

(860) 297-0938

Fax

(860) 293-6338

NPI assigned

Apr 8, 2008

Sex

Female

Sole proprietor

Yes

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 CT

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

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.

• State of Connecticut

  • Psychiatric Hospital
  • Hartford, CT
  • NPI 1487689022
  Medicare reassignment

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

{
    "created_epoch": "1207612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207612800000",
    "number": "1053584359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 KING ST",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061081014",
            "telephone_number": "860-297-0938",
            "fax_number": "860-297-6338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 VINE ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061121639",
            "telephone_number": "860-297-0938",
            "fax_number": "860-293-6338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO-BURGOS",
        "first_name": "MAYRA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-08",
        "last_updated": "2008-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "004689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marian Santandreu Mirabal, PSYD
• Jamie Santaniello, PMHNP-BC, APRN
• Patricia Santi, LMFT
• Cristal Santiago Hernandez
• Ismael Santiago Lamb, LCSW
• Joanne Santiago
• Kimberly Ann Santiago, PA-C
• Magda I Santiago
• John Michael Santopietro, M.D.
• Andrea L. Santos Portilla, M.D.

• Clinical Social Worker in Hartford, CT
• Providers in Hartford, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2008; 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.