Active NPI
Elena Marie Burdick
- Clinical Social Worker
- Los Angeles, CA
National Provider Identifier
1154713162
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 112181
- Practice address
- 6762 Lexington Ave
Los Angeles, CA 90038-1217 - Phone
- (323) 380-7590
- NPI assigned
- Feb 27, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 90012 | CA | |
| Clinical Social Worker | 1041C0700X | 112181 | CA | Primary |
Addresses
Primary practice location
6762 Lexington Ave
Los Angeles, CA 90038-1217
Mailing address
6762 Lexington Ave
Los Angeles, CA 90038-1217
Phone (323) 380-7590
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
| License | State | Type | Specialty |
|---|---|---|---|
| 112181 | CA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
| 90012 | CA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1424995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670284800000",
"number": "1154713162",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6762 LEXINGTON AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900381217",
"telephone_number": "323-380-7590"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6762 LEXINGTON AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900381217",
"telephone_number": "323-380-7590"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURDICK",
"first_name": "ELENA",
"middle_name": "MARIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-02-27",
"last_updated": "2022-12-06",
"certification_date": "2022-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "90012",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "112181",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.