Active NPI
Robert Alan Burke
- Clinical Social Worker
- Lakewood, OH
National Provider Identifier
1497413967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- I.0005908-SUPV
- Practice address
- 14650 Detroit Ave Ste 110
Lakewood, OH 44107-4210 - Phone
- (617) 229-5415
- NPI assigned
- Dec 2, 2021
- Last updated
- Dec 2, 2021
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | I.0005908-SUPV | OH | Primary |
Addresses
Primary practice location
14650 Detroit Ave Ste 110
Lakewood, OH 44107-4210
Mailing address
1000 Jefferson St Ste 2C
Lynchburg, VA 24504-1724
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 |
|---|---|---|---|
| I.0005908-SUPV | OH | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thrive Counseling LLC | Current | Accepting new patients |
Locations
14650 Detroit Ave
Ste 110
Lakewood, OH 44107
Phone (216) 238-3622
1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263
Organizations & group practices 1
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": "1638403200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638403200000",
"number": "1497413967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 JEFFERSON ST STE 2C",
"city": "LYNCHBURG",
"state": "VA",
"postal_code": "245041724"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14650 DETROIT AVE STE 110",
"city": "LAKEWOOD",
"state": "OH",
"postal_code": "441074210",
"telephone_number": "617-229-5415"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURKE",
"first_name": "ROBERT",
"middle_name": "ALAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-12-02",
"last_updated": "2021-12-02",
"certification_date": "2021-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OH",
"license": "I.0005908-SUPV",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lakewood, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.