Individual provider Active NPI

Bobbi Burg, LCSW

  • Clinical Social Worker
  • Lees Summit, MO
National Provider Identifier
1194156810
Registry record updated Jan 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
305 SW Market St # 8
Lees Summit, MO 64063-2388
Phone
(816) 702-8778
Fax
(816) 203-4499
NPI assigned
Dec 5, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2021

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 Primary
Mental Health Counselor 101YM0800X 2013020399 MO

Addresses

Primary practice location

305 SW Market St # 8
Lees Summit, MO 64063-2388

Mailing address

1023 NE Deerbrook Ter
Lees Summit, MO 64086-6774
Phone (816) 536-7431

Other practice location 1

6 Victory Dr
Liberty, MO 64068
Phone (816) 536-7431

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20161018002981 MO Practitioner - Clinical Social Worker 5092003491 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

660 SE Bayberry LN
Suite 101F
Lees Summit, MO 64063-4264
Phone (816) 702-8778

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2013020399MOMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Bobbi J Burg LCSW LLC Clinical CurrentSince Oct 1, 2019 Accepting new patients

Locations

688 SE Bayberry Ln
Ste 103A
Lees Summit, MO 64063
Phone (816) 702-8778

215 SE Douglas St
Lees Summit, MO 64063
Phone (619) 681-4275

668 SE Bayberry Ln
Ste 101
Lees Summit, MO 64063
Phone (816) 260-6982

305 SW Market St
#8
Lees Summit, MO 64063
Phone (816) 702-8778

Organizations & group practices 1

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": "1386201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611705600000",
    "number": "1194156810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1023 NE DEERBROOK TER",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640866774",
            "telephone_number": "816-536-7431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 SW MARKET ST # 8",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640632388",
            "telephone_number": "816-702-8778",
            "fax_number": "816-203-4499"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6 Victory Dr",
            "address_purpose": "LOCATION",
            "city": "Liberty",
            "state": "MO",
            "postal_code": "64068",
            "country_code": "US",
            "telephone_number": "816-536-7431",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURG",
        "first_name": "BOBBI",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-05",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MO",
            "license": "2013020399",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lees Summit, MO

Sources for this page

Verify at the official NPI Registry.