Mary Burke

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

690 Cleveland Ave S Ste 100
Saint Paul, MN 55116-1319

Phone

(651) 493-8412

NPI assigned

Jan 12, 2023

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

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 and National Provider Directory roles.

• The Bridge Autism Clinic LLC

  • Adolescent and Children Mental Health Clinic/Center
  • St Paul, MN
  • NPI 1568017374
  NPD

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

{
    "created_epoch": "1673481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673481600000",
    "number": "1558075614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 CLEVELAND AVE S STE 100",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551161319",
            "telephone_number": "651-493-8412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 CLEVELAND AVE S STE 100",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551161319",
            "telephone_number": "651-493-8412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKE",
        "first_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-12",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Charles Burggraff, LGSW
• Elizabeth Burgos, LICSW
• Matthew Scott Burgstahler, MD
• Bryce Buri, EXERCISE PHYSIOLOGY
• Christopher Kenneth Burke, PH.D.
• Sara Marie Burke, LPCC
• Tiffany Burke
• Adam John Houser Burman, PA-C
• Aaron Michael Burnett, MD
• Courtney Burnett, MD

• Behavior Technician in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Behavior Technician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 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.