Active NPI
Adam Burton Burke
- Mental Health Counselor
- Panama City, FL
National Provider Identifier
1386919116
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 12258
- Practice address
- 2711 W 15TH St
Panama City, FL 32401-1366 - Phone
- (850) 769-6001
- NPI assigned
- Mar 12, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | |||
| Clinical Social Worker | 1041C0700X | 12258 | FL | |
| Clinical Social Worker | 1041C0700X | 3615 | FL | |
| School Social Worker | 1041S0200X | 962188 | FL | |
| Mental Health Counselor | 101YM0800X | 12258 | FL | Primary |
Addresses
Primary practice location
2711 W 15TH St
Panama City, FL 32401-1366
Mailing address
599 Posadas Cir
Punta Gorda, FL 33983-5878
Phone (850) 380-1203
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 |
|---|---|---|---|
| 12258 | FL | MD | Mental Health Counselor |
| 3615 | FL | MD | Clinical Social Worker |
| 962188 | FL | MD | School Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1331510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646006400000",
"number": "1386919116",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "599 POSADAS CIR",
"city": "PUNTA GORDA",
"state": "FL",
"postal_code": "339835878",
"telephone_number": "850-380-1203"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2711 W 15TH ST",
"city": "PANAMA CITY",
"state": "FL",
"postal_code": "324011366",
"telephone_number": "850-769-6001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURKE",
"first_name": "ADAM",
"middle_name": "BURTON",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-03-12",
"last_updated": "2022-02-28",
"certification_date": "2022-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "12258",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "3615",
"primary": false
},
{
"code": "1041S0200X",
"taxonomy_group": "",
"desc": "Social Worker, School",
"state": "FL",
"license": "962188",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "12258",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Panama City, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 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.