Active NPI
Jacquin Burns, LCSW
- Clinical Social Worker
- Cannon Afb, NM
National Provider Identifier
1346792843
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- C-09291
- Practice address
- 27TH Special Operations Medical Group
224 W D.L. Ingram Avenue, BLDG. 1408
Cannon Afb, NM 88103-5159 - Phone
- (575) 268-9504
- NPI assigned
- Oct 31, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | C-09291 | NM | Primary |
Addresses
Primary practice location
27TH Special Operations Medical Group
224 W D.L. Ingram Avenue, BLDG. 1408
Cannon Afb, NM 88103-5159
Mailing address
122 Cochran Ave E BLDG 575
Cannon Afb, NM 88103-5159
Phone (575) 268-9504
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
| License | State | Type | Specialty |
|---|---|---|---|
| C-09291 | NM | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1477872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753315200000",
"number": "1346792843",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "122 COCHRAN AVE E BLDG 575",
"city": "CANNON AFB",
"state": "NM",
"postal_code": "881035159",
"telephone_number": "575-268-9504",
"fax_number": "575-763-0041"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27TH SPECIAL OPERATIONS MEDICAL GROUP",
"address_2": "224 W D.L. INGRAM AVENUE, BLDG. 1408",
"city": "CANNON AFB",
"state": "NM",
"postal_code": "881035159",
"telephone_number": "575-268-9504"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURNS",
"first_name": "JACQUIN",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-10-31",
"last_updated": "2025-07-24",
"certification_date": "2025-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NM",
"license": "C-09291",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cannon Afb, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.