Jeremy J Burtch, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

3249125 Issued in WI

Practice address

602 Pleasant Oak Drive
Oregon, WI 53575-3648

Phone

(608) 835-5050

Fax

(608) 835-5010

NPI assigned

Nov 3, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Restoring Balance Counseling LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Jefferson, WI
  • NPI 1528556404
  NPD Authorized official
• Oregon Mental Health Services

  • Community/Behavioral Health Agency
  • Oregon, WI
  • NPI 1932330008
  NPD (past)
• Oregon Mental Health SVS

  • Adolescent and Children Mental Health Clinic/Center
  • Oregon, WI
  • NPI 1508940370
  NPD (past)

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245319078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 PLEASANT OAK DR",
            "city": "OREGON",
            "state": "WI",
            "postal_code": "535753648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 PLEASANT OAK DRIVE",
            "city": "OREGON",
            "state": "WI",
            "postal_code": "535753648",
            "telephone_number": "608-835-5050",
            "fax_number": "608-835-5010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURTCH",
        "first_name": "JEREMY",
        "middle_name": "J",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "3249125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40942700",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED PROF COUNSELOR",
            "identifier": "3249125",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Formella Brooks, DO
• Grace Beverly Brown
• Lori A Brown, PA-C
• Jason Allen Buenger, PHARM.D
• Kloe Catherine Burg, APSW
• Rebecca Ann Burton, RN
• Bonnie Buschke
• Roxanne Butterfield, RN
• Careway Services LLC
• Robert J Carlon

• Mental Health Counselor in Oregon, WI
• Providers in Oregon, WI by specialty
• Mental Health Counselor in Wisconsin

• 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.