Individual provider Active NPI

Patricia A Burke, MSW, LCSW

  • Clinical Social Worker
  • Biddeford, ME
National Provider Identifier
1124163480
Registry record updated Oct 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC3684 Issued in ME
Practice address
411 Alfred St
Biddeford, ME 04005-3741
Phone
(207) 625-7012
NPI assigned
Feb 21, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LC3684 ME Primary
Clinical Social Worker 1041C0700X 105393 MA

Addresses

Primary practice location

411 Alfred St
Biddeford, ME 04005-3741

Mailing address

855 Pool St
Biddeford, ME 04005-9212
Phone (207) 625-7012

Other identifiers 1

IdentifierTypeStateIssuer
017101OtherMEANTHEM BXBS PROVIDER

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
105393MAMDClinical Social Worker
LC3684MEMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412899200000",
    "number": "1124163480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 POOL ST",
            "city": "BIDDEFORD",
            "state": "ME",
            "postal_code": "040059212",
            "telephone_number": "207-625-7012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 ALFRED ST",
            "city": "BIDDEFORD",
            "state": "ME",
            "postal_code": "040053741",
            "telephone_number": "207-625-7012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKE",
        "first_name": "PATRICIA",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2014-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC3684",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "105393",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BXBS PROVIDER",
            "identifier": "017101",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Biddeford, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.