Individual provider Active NPI

Shanika La'Tia Burke, LCSW-C

  • Clinical Social Worker
  • Windsor Mill, MD
National Provider Identifier
1114260262
Registry record updated Mar 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
16318 Issued in MD
Practice address
3104 Lord Baltimore Dr Ste 202
Windsor Mill, MD 21244-5802
Phone
(443) 977-8879
NPI assigned
Mar 27, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 16318 MD Primary

Addresses

Primary practice location

3104 Lord Baltimore Dr Ste 202
Windsor Mill, MD 21244-5802

Mailing address

825 Amherst LN
Westminster, MD 21158-4350
Phone (443) 977-8879

Other practice location 1

825 Amherst Ln
Westminster, MD 21158-4350
Phone (443) 977-8879

Other identifiers 1

IdentifierTypeStateIssuer
443232100MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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

Enrollment IDStateProvider typePAC IDDetails
I20221123003006 MD Practitioner - Clinical Social Worker 0648648584 Practice locations: Owings Mills, MD

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16318MDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Her Mind Her Body Clinical Associates Current Accepting new patients
Her Mind Her Body Wellness Program Current Accepting new patients
Her Mind Her Body Clinical Associates Current Accepting new patients

Locations

10711 Red Run Blvd
Ste 112
Owings Mills, MD 21117
Phone (410) 298-4642

3104 Lord Baltimore Dr
Ste 202
Windsor Mill, MD 21244
Phone (410) 298-4642

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.

NPI Registry JSON

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

{
    "created_epoch": "1364342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772755200000",
    "number": "1114260262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 AMHERST LN",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211584350",
            "telephone_number": "443-977-8879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3104 LORD BALTIMORE DR STE 202",
            "city": "WINDSOR MILL",
            "state": "MD",
            "postal_code": "212445802",
            "telephone_number": "443-977-8879"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "825 Amherst Ln",
            "address_purpose": "LOCATION",
            "city": "Westminster",
            "state": "MD",
            "postal_code": "211584350",
            "country_code": "US",
            "telephone_number": "443-977-8879",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURKE",
        "first_name": "SHANIKA",
        "middle_name": "LA'TIA",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-27",
        "last_updated": "2026-03-06",
        "certification_date": "2026-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "16318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "443232100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Windsor Mill, MD

Sources for this page

Verify at the official NPI Registry.