Individual provider Active NPI

Lisa Ann Burke, MSW LCSW

  • Clinical Social Worker
  • Green Bay, WI
National Provider Identifier
1437204138
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6965-123 Issued in WI
Practice address
916 Willard Dr Ste 125F
Green Bay, WI 54304-0008
Phone
(920) 798-8480
NPI assigned
Jan 24, 2007
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6965-123 WI Primary

Addresses

Primary practice location

916 Willard Dr Ste 125F
Green Bay, WI 54304-0008

Mailing address

916 Willard Dr Ste 125F
Green Bay, WI 54304-0008

Other identifiers 1

IdentifierTypeStateIssuer
40944100MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20241030003381 WI Practitioner - Clinical Social Worker 6204369184

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6965-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
A Fresh Start Counseling and Wellness LLC Clinical CurrentSince Sep 14, 2025 Accepting new patients
Innovative Counseling Inc Past Accepting new patients

Locations

916 Willard Dr
Ste 125F
Green Bay, WI 54304
Phone (920) 284-9676

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1437204138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "916 WILLARD DR STE 125F",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543040008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "916 WILLARD DR STE 125F",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543040008",
            "telephone_number": "920-798-8480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKE",
        "first_name": "LISA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "MSW LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "6965-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40944100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.