Erica Burgoon, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS016552 Issued in PA

Practice address

525 S 4TH St
Suite 417
Philadelphia, PA 19147-1570

Phone

(267) 861-3685

NPI assigned

Sep 24, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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.

• Equilibria Mental Health Services

  • Community/Behavioral Health Agency
  • Philadelphia, PA
  • NPI 1225792872
  Medicare reassignment

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

{
    "created_epoch": "1411516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414108800000",
    "number": "1417359167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 WESTMONT AVE",
            "city": "HADDONFIELD",
            "state": "NJ",
            "postal_code": "080331716",
            "telephone_number": "856-816-7098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 S 4TH ST",
            "address_2": "SUITE 417",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191471570",
            "telephone_number": "267-861-3685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGOON",
        "first_name": "ERICA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-24",
        "last_updated": "2014-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS016552",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "DE",
            "license": "B1-0000957",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Marie Burgese
• Christina Burgess
• Mikki-Lee Burgess, LPC
• Sarah Burgess, LPC, ATR-BC
• Donna Green Burgmayer, CRNP
• Burholme Emergency Care Specialists LLC
• Ashlie L Burkart, M.D., C.M.
• Burke Medical PC
• Alan M Burke, MD
• Allyson Elizabeth Burke, CRNP

• Clinical Psychologist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Clinical Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.