Nicolette D Burnette, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

17221 Issued in SC

Practice address

2117 Gervais St
Columbia, SC 29204

Phone

(803) 744-0540

NPI assigned

Jun 26, 2023

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

Other names 1

• Miss Nicolette D Bookert Former name

Medicare fee-for-service enrollment

Enrolled in SC

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

State licenses

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.

• Eau Claire Cooperative Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Columbia, SC
  • NPI 1346249430

  Social Worker

  Medicare reassignment NPD
• Destination Fortified Counseling & Wellness, LLC

  • Clinical Social Worker
  • Columbia, SC
  • NPI 1245111871
  NPD Authorized official
• Eau Claire Cooperative Health Center ,Inc.

  • Federally Qualified Health Center (FQHC)
  • Columbia, SC
  • NPI 1588375653
  NPD

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

{
    "created_epoch": "1687737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1073299954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8532",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29202",
            "telephone_number": "803-238-6856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2117 GERVAIS ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29204",
            "telephone_number": "803-744-0540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNETTE",
        "first_name": "NICOLETTE",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-26",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "17221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLETTE",
            "last_name": "BOOKERT",
            "middle_name": "D",
            "prefix": "MISS",
            "credential": "LISW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lynn M Burnett, CCCA/SLP
• Sarah French Burnett, CCC-SLP, CERT AVT
• Walter Magill Burnett, PTA
• Carolyn Burnette, APRN
• Mary Michele Burnette, PH. D.
• Nola Covington Burnette, LISW-CP
• Marjorie Arlene Burniston, MOT, OTR/L
• Joan Marie Burns, DNP, APRN, PMHNP-BC
• Kendra Burns
• Latoyla Burns

• Clinical Social Worker in Columbia, SC
• Providers in Columbia, SC by specialty
• Clinical Social Worker in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; 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.