Individual provider Active NPI

Catherine L Burcham, LCSW

  • Clinical Social Worker
  • Galax, VA
National Provider Identifier
1235386343
Registry record updated Dec 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904007331 Issued in VA
Practice address
205 W Grayson St
Galax, VA 24333-2811
Phone
(276) 233-1263
Fax
(276) 238-8342
NPI assigned
Aug 20, 2008
Last updated
Dec 10, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2019

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 0904007331 VA Primary

Addresses

Primary practice location

205 W Grayson St
Galax, VA 24333-2811

Mailing address

205 W Grayson St
Galax, VA 24333-2811
Phone (276) 235-2128

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20101020000836 VA Practitioner - Clinical Social Worker 0749349033 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

788 E Stuart Dr
Suite a
Galax, VA 24333-2313
Phone (276) 233-1263

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Peace of Mind Counseling Service Past Accepting new patients
Greater Trenton CMHC Inc. Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1219190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575936000000",
    "number": "1235386343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 W GRAYSON ST",
            "city": "GALAX",
            "state": "VA",
            "postal_code": "243332811",
            "telephone_number": "276-235-2128",
            "fax_number": "276-238-8342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 W GRAYSON ST",
            "city": "GALAX",
            "state": "VA",
            "postal_code": "243332811",
            "telephone_number": "276-233-1263",
            "fax_number": "276-238-8342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURCHAM",
        "first_name": "CATHERINE",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-20",
        "last_updated": "2019-12-10",
        "certification_date": "2019-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904007331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galax, VA

Sources for this page

Verify at the official NPI Registry.