Jacqueline Debra Burgess, CRPA

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

CRPA-5635 Issued in NY

Practice address

3 Corporate Dr
Peekskill, NY 10566-1810

Phone

(914) 257-3500

NPI assigned

Jul 31, 2023

Last updated

Jul 31, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Lexington Center for Recovery, Inc.

  • Methadone Clinic
  • Peekskill, NY
  • NPI 1487709671
  NPD

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

{
    "created_epoch": "1690761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1437830452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 COLLEGE AVE APT 1B",
            "city": "SLEEPY HOLLOW",
            "state": "NY",
            "postal_code": "105912740",
            "telephone_number": "914-839-7004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 CORPORATE DR",
            "city": "PEEKSKILL",
            "state": "NY",
            "postal_code": "105661810",
            "telephone_number": "914-257-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGESS",
        "first_name": "JACQUELINE",
        "middle_name": "DEBRA",
        "credential": "CRPA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-31",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "NY",
            "license": "CRPA-5635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janet K Brooks, C.N.M.
• Patricia Brooks, LCSW
• Melody E Goode Brown
• Allyson Elizabeth Buck-Vasquez, CCC-SLP
• Adriana Burbridge, RPH
• Laura Burkhalter
• David Lloyd Burns, MD
• Robert Buryakov, LMSW
• Karen Buttacavoli, LMSW
• Edwin Calero, CASAC

• Peer Specialist in Peekskill, NY
• Providers in Peekskill, NY by specialty
• Peer Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; 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.