Individual provider Active NPI

Erica Lynne Burditt, MSW

  • Clinical Social Worker
  • Waltham, MA
National Provider Identifier
1164572947
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
113562 Issued in MA
Practice address
77 Rumford Ave
Childrens Charter
Waltham, MA 02453-3872
Phone
(781) 894-4307
NPI assigned
Jan 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 113562 MA Primary

Addresses

Primary practice location

77 Rumford Ave
Childrens Charter
Waltham, MA 02453-3872

Mailing address

77 Rumford Ave
Childrens Charter
Waltham, MA 02453-3872

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
113562MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164572947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 RUMFORD AVE",
            "address_2": "CHILDRENS CHARTER",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024533872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 RUMFORD AVE",
            "address_2": "CHILDRENS CHARTER",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024533872",
            "telephone_number": "781-894-4307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURDITT",
        "first_name": "ERICA",
        "middle_name": "LYNNE",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "113562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waltham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.