Individual provider Active NPI

Heather Burack, LCSW

  • Clinical Social Worker
  • Brooklyn, NY
National Provider Identifier
1720304108
Registry record updated Apr 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
076446 Issued in NY
Practice address
294 Parkside Ave
Brooklyn, NY 11226-1479
Phone
(917) 553-6827
NPI assigned
Apr 11, 2010
Last updated
Apr 11, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2010

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 076446 NY Primary

Addresses

Primary practice location

294 Parkside Ave
Brooklyn, NY 11226-1479

Mailing address

294 Parkside Ave
Brooklyn, NY 11226-1479
Phone (917) 553-6827

Other identifiers 1

IdentifierTypeStateIssuer
076446OtherNYNEW YORK STATE LICENSE

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1270944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270944000000",
    "number": "1720304108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "294 PARKSIDE AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112261479",
            "telephone_number": "917-553-6827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "294 PARKSIDE AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112261479",
            "telephone_number": "917-553-6827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURACK",
        "first_name": "HEATHER",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-11",
        "last_updated": "2010-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "076446",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW YORK STATE LICENSE",
            "identifier": "076446",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2010; 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.