Individual provider Active NPI

Kaitlin Ann Burke

  • Mental Health Counselor
  • Salem, MA
National Provider Identifier
1366501173
Registry record updated Sep 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
35 Congress St
Suite 214
Salem, MA 01970-5529
Phone
(978) 542-1951
Fax
(978) 542-1954
NPI assigned
Dec 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

35 Congress St
Suite 214
Salem, MA 01970-5529

Mailing address

7 Howard Ave
Peabody, MA 01960-6100
Phone (978) 697-0456

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20170816000634 MA Practitioner - Clinical Social Worker 3971875618 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4 -6 Water St
Amesbury, MA 01913-2736
Phone (978) 712-9698

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lavender Moon Counseling and Healing CurrentSince Sep 7, 2022 Accepting new patients
SB Transitional Sub, LLC CurrentSince May 17, 2021 Accepting new patients
South Bay Mental Health Past Accepting new patients

Locations

103 Commercial St
Brockton, MA 02302
Phone (508) 521-1020

1115 W Chestnut St
Ste 202
Brockton, MA 02301
Phone (508) 824-1355

103 Commercial St
Ste 2
Brockton, MA 02302

360 Merrimack St
Ste 9
Lawrence, MA 01843
Phone (978) 552-4000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347840000000",
    "number": "1366501173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 HOWARD AVE",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019606100",
            "telephone_number": "978-697-0456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 CONGRESS ST",
            "address_2": "SUITE 214",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019705529",
            "telephone_number": "978-542-1951",
            "fax_number": "978-542-1954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKE",
        "first_name": "KAITLIN",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-07",
        "last_updated": "2012-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, MA

Sources for this page

Verify at the official NPI Registry.