Burnley Workshop of the Poconos

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

License

CER-00093533 Issued in PA

Legal business name

BURNLEY WORKSHOP OF THE POCONOS

Practice address

4219 Manor Dr
Stroudsburg, PA 18360-9451

Phone

(570) 992-6616

Fax

(570) 992-5052

NPI assigned

Mar 12, 2007

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Robert Ames

Title

Vice President

Phone

(570) 348-5371

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1386776508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4219 MANOR DR",
            "city": "STROUDSBURG",
            "state": "PA",
            "postal_code": "183609451",
            "telephone_number": "570-992-6616",
            "fax_number": "570-992-5052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4219 MANOR DR",
            "city": "STROUDSBURG",
            "state": "PA",
            "postal_code": "183609451",
            "telephone_number": "570-992-6616",
            "fax_number": "570-992-5052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BURNLEY WORKSHOP OF THE POCONOS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "AMES",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "570-348-5371",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "PA",
            "license": "213490",
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "PA",
            "license": "CER-00093533",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10000362007",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly R Brown, D.O.
• Najwa Brown, RPH
• Simone Brown
• Jasmine Luz Buhtanicvela, MSW, LSW
• Richard Alan Bullock Jr.
• Shantele Burton
• Kimberly Calafiore, LPC
• Kellyann Cameron, LCSW
• Carbon Monroe Pike MH DS
• Carbon-Monroe-Pike MH/Mr Program

• Developmentally Disabled Services Day Training Agency in Stroudsburg, PA
• Providers in Stroudsburg, PA by specialty
• Developmentally Disabled Services Day Training Agency in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.