Individual provider Active NPI

Kenneth R Burns, LCSW

  • Clinical Social Worker
  • Hauppauge, NY
National Provider Identifier
1508130089
Registry record updated Mar 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
082535 Issued in NY
Practice address
1 Rabro Dr Ste 10
Hauppauge, NY 11788-4270
Phone
(631) 257-5900
Fax
(631) 706-4727
NPI assigned
Mar 1, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2020

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 082535 NY Primary

Addresses

Primary practice location

1 Rabro Dr Ste 10
Hauppauge, NY 11788-4270

Mailing address

1 Rabro Dr Ste 10
Hauppauge, NY 11788-4270
Phone (631) 257-5900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20161215000530 NY Practitioner - Clinical Social Worker 2567742224 Reassigns benefits to 1 organization
Practice locations: Smithtown, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
State University of New York at Stony Brook, School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1 Rabro Dr
Suite 10
Hauppauge, NY 11788-4270
Phone (631) 257-5900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
082535NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Transformations Counseling Group LCSW PLLC Clinical CurrentSince Feb 1, 2020 Accepting new patients

Locations

1 Rabro Dr
Ste 10
Hauppauge, NY 11788
Phone (631) 234-7889

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1330560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585353600000",
    "number": "1508130089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 RABRO DR STE 10",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117884270",
            "telephone_number": "631-257-5900",
            "fax_number": "631-257-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 RABRO DR STE 10",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117884270",
            "telephone_number": "631-257-5900",
            "fax_number": "631-706-4727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNS",
        "first_name": "KENNETH",
        "middle_name": "R",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-03-01",
        "last_updated": "2020-03-28",
        "certification_date": "2020-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "082535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hauppauge, NY

Sources for this page

Verify at the official NPI Registry.