Evelyn Burroughs, CASAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

13118 Issued in NY

Practice address

1215 Stratford Ave
Bronx, NY 10472-2501

Phone

(718) 328-2605

Fax

(718) 328-2609

NPI assigned

Mar 3, 2009

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

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.

• The Pac Program of the Bronx

  • Clinic/Center
  • Bronx, NY
  • NPI 1497981328
  NPD (past)

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

{
    "created_epoch": "1236038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401667200000",
    "number": "1497995476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215-1217 STRATFORD AVENUE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10472",
            "telephone_number": "718-328-2605",
            "fax_number": "718-328-2609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 STRATFORD AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104722501",
            "telephone_number": "718-328-2605",
            "fax_number": "718-328-2609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURROUGHS",
        "first_name": "EVELYN",
        "credential": "CASAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-03",
        "last_updated": "2014-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "13118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Latoya Burrell, LPN
• Marisa Burrell, LPN
• Nicole Elizabeth Burrell, LPN
• Chereece Africa Burris, LPN
• Nakashia Burrough
• Hunter Douglas Burroughs, MD
• Jamel Burroughs, LCSW
• Joanne Burroughs, LMSW
• Rondell Burroughs
• Althea Burrowes, M.D.

• Addiction (Substance Use Disorder) Counselor in Bronx, NY
• Providers in Bronx, NY by specialty
• Addiction (Substance Use Disorder) Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2014; 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.