Jennifer Burroughs

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

2085 Issued in NC

Practice address

4819 Emperor Blvd
Durham, NC 27703-0089

Phone

(919) 438-3508

NPI assigned

Feb 12, 2015

Last updated

Nov 9, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Mar 20, 2024 through Mar 20, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• New Wave Counseling PLLC

  • Mental Health Counselor
  • Durham, NC
  • NPI 1134849094

  Addiction (Substance Use Disorder)

  NPD Authorized official

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

{
    "created_epoch": "1423699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667952000000",
    "number": "1689065690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10332 RIVER BANK DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276148930",
            "telephone_number": "949-433-2755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4819 EMPEROR BLVD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277030089",
            "telephone_number": "919-438-3508"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10332 River Bank Dr",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276148930",
            "country_code": "US",
            "telephone_number": "949-433-2755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURROUGHS",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-12",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-21497",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "2085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walter Woodrow Burns Jr., MD
• Sheri Ahern Burnsed, PT
• Maya Shapiro Miller Burr
• Rebecca Burrington, DO
• Jasmine Burroughs, RD, LDN
• Brian John Burrows, M.D.
• Michael Mohan Burt, MD
• Amanda Burton
• Brian Burton
• Christina Burton, PA-C

• Mental Health Counselor in Durham, NC
• Providers in Durham, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.