Active NPI
Marjorie Demirs Burgess, LPC
- Professional Counselor
- Gardiner, ME
National Provider Identifier
1568672251
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 804
- Practice address
- 37 Brunswick Ave
Gardiner, ME 04345-2154 - Phone
- (207) 582-2663
- NPI assigned
- May 23, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 804 | ME | Primary |
Addresses
Primary practice location
37 Brunswick Ave
Gardiner, ME 04345-2154
Mailing address
15 Green St
Gardiner, ME 04345-2305
Phone (207) 582-2663
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 |
|---|---|---|---|
| 804 | ME | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1568672251",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 GREEN ST",
"city": "GARDINER",
"state": "ME",
"postal_code": "043452305",
"telephone_number": "207-582-2663"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "37 BRUNSWICK AVE",
"city": "GARDINER",
"state": "ME",
"postal_code": "043452154",
"telephone_number": "207-582-2663"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURGESS",
"first_name": "MARJORIE",
"middle_name": "DEMIRS",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "ME",
"license": "804",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gardiner, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.