Mike Vincent Burckhard, LICSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

120 Issued in ND

Practice address

315 Main St S
Suite 315
Minot, ND 58701-3956

Phone

(701) 852-5876

Fax

(701) 852-5883

NPI assigned

Oct 8, 2005

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in ND

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

Specialty

Clinical Social Worker

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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.

• Burckhard Clinic, P. C.

  • Adult Mental Health Clinic/Center
  • Minot, ND
  • NPI 1346305190
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1128729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416268800000",
    "number": "1104814789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 MAIN ST S STE 315",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587013956",
            "telephone_number": "701-852-5876",
            "fax_number": "701-852-5883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 MAIN ST S",
            "address_2": "SUITE 315",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587013956",
            "telephone_number": "701-852-5876",
            "fax_number": "701-852-5883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURCKHARD",
        "first_name": "MIKE",
        "middle_name": "VINCENT",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-08",
        "last_updated": "2014-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ND",
            "license": "120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS ID NUMBER",
            "identifier": "17415",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "19118",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Burckhard Orthodontics, PLLC
• Tifany A Burckhard-Teets, DC
• Andrea Marie Burckhard, D.C.
• Jason Burckhard, DDS
• Kathryn Marie Burckhard
• Natalie Burckhard
• Katharyn A Burgardt, FNP-C
• Jean M Burke, LPCC
• Lisa M Burke, O.T.R.L.
• Eddie E Burl, LAC

• Mental Health Counselor in Minot, ND
• Providers in Minot, ND by specialty
• Mental Health Counselor in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2014; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.