Jessica E Burke, LMHC
Individual provider Active NPI Professional Counselor · Revere, MA
NPI 1639829922 · NPPES record last updated Mar 28, 2022
Key facts
- NPI
- 1639829922
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 12192 (MA)
- Practice address
- 174 Crest Ave
Revere, MA 02151-4181 - Phone
- (508) 314-5023
- NPI assigned
- Mar 28, 2022
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12192 | MA | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 12192 | MA | Yes |
Addresses
Primary practice location
174 Crest Ave
Revere, MA 02151-4181
Mailing address
174 Crest Ave
Revere, MA 02151-4181
Phone (508) 314-5023
Other providers in Revere, MA
- Melissa Brown
- Robert Thomas Bruzzese
- Jessica Bryski
- Drew Bunker
- Alannah Rose Burke
- Susan Curley Burton
- Melissa Bustamante
- Thomas Byrne
- Cambridge Public Health Commission
- Debbie Ann Campbell
All providers in Revere, MA · Professional Counselor in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 28, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.