Jessica Brooke Burgess, LMSW

Individual provider Active NPI Clinical Social Worker · Rockford, MI

NPI 1104115104 · NPPES record last updated Nov 28, 2023

Key facts

NPI
1104115104
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
6801088186 (MI)
Practice address
7475 Ceilcrest LN NE
Rockford, MI 49341-8824
Phone
(616) 299-5847
NPI assigned
Mar 31, 2011
Sex
Female
Sole proprietor
No

Organizations & group practices 3

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Jessica Burgess Counseling LLC Clinical Current
since Dec 3, 2023
Accepting new patients
D a Blodgett-St Johns Clinical Past
since Oct 10, 2015
Accepting new patients
D.a. Blodgett - St. John'S Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801088186 MI Yes

Addresses

Primary practice location

7475 Ceilcrest LN NE
Rockford, MI 49341-8824

Mailing address

805 Leonard St NE
Grand Rapids, MI 49503-1138
Phone (616) 451-2021

Other names

  • Jessica Brooke Ritter Former name

Other providers in Rockford, MI

All providers in Rockford, MI · Clinical Social Worker in Michigan

Sources for this page

Verify at the official NPI Registry.