Active NPI
Evelyn G. Burkhouse, LCSW-C
- Clinical Social Worker
- Elkton, MD
National Provider Identifier
1093865958
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 10594
- Practice address
- 200 Booth St
Elkton, MD 21921-5657 - Phone
- (410) 996-5014
- Fax
- (410) 996-5197
- NPI assigned
- Jan 11, 2007
- Sex
- Female
- 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 | 10594 | MD | Primary |
Addresses
Primary practice location
200 Booth St
Elkton, MD 21921-5657
Mailing address
331 Old Chestnut Rd
Elkton, MD 21921-7212
Phone (410) 398-9749
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10594 | MD | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1093865958",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "331 OLD CHESTNUT RD",
"city": "ELKTON",
"state": "MD",
"postal_code": "219217212",
"telephone_number": "410-398-9749"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 BOOTH ST",
"city": "ELKTON",
"state": "MD",
"postal_code": "219215657",
"telephone_number": "410-996-5014",
"fax_number": "410-996-5197"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURKHOUSE",
"first_name": "EVELYN",
"middle_name": "G.",
"name_prefix": "Ms.",
"credential": "LCSW-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "10594",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elkton, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.