Active NPI
Jennifer Burleson, PSY.D
- Psychologist
- Louisville, KY
National Provider Identifier
1457413478
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 20041903A
- Practice address
- 214 Breckenridge Lane Suite 207
Louisville, KY 40207 - Phone
- (502) 386-9286
- NPI assigned
- Dec 15, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 20041903A | IN | Primary |
Addresses
Primary practice location
214 Breckenridge Lane Suite 207
Louisville, KY 40207
Mailing address
3600 Warner Ave
Louisville, KY 40207-3730
Phone (502) 386-9286
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20041903A | IN | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166140800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315353600000",
"number": "1457413478",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3600 WARNER AVE",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402073730",
"telephone_number": "502-386-9286"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "214 BRECKENRIDGE LANE SUITE 207",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "40207",
"telephone_number": "502-386-9286"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURLESON",
"first_name": "JENNIFER",
"credential": "PSY.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-15",
"last_updated": "2011-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "IN",
"license": "20041903A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.