Jenice Burgos, LMSW

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

107043 Issued in NY

Practice address

760 Broadway # 5A206
Brooklyn, NY 11206-5383

Phone

(718) 963-5893

Fax

(718) 630-3138

NPI assigned

Aug 5, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1628121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628121600000",
    "number": "1174297865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 GATES AVE APT 1R",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112375669",
            "telephone_number": "347-553-6798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 BROADWAY # 5A206",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112065383",
            "telephone_number": "718-963-5893",
            "fax_number": "718-630-3138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGOS",
        "first_name": "JENICE",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-05",
        "last_updated": "2021-08-05",
        "certification_date": "2021-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NY",
            "license": "107043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100148153",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gemma Burgio, L-CAT, ATR-BC, MPS
• Maria R Burgio, PH.D.
• Gilbert Burgos, MD
• Jaynee M Burgos, SLP
• Jeannette Burgos, LCSW
• Nakia Zamalia Burgos
• Naomi Esther Burgos
• Valentina Lourdes Burgos
• Wilfred Charles Burgoyne, LCSW
• Burgundy Medical PC

• Adult Mental Health Clinic/Center in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Adult Mental Health Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2021; 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.