Jesse Marie Burke, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801098662 Issued in MI

Practice address

300 W Johnson Street
Hart, MI 49420

Phone

(231) 873-0586

Fax

(616) 554-5555

NPI assigned

Dec 29, 2015

Last updated

Oct 6, 2020By 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

Other names 1

• Jesse Marie Kistler Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• District Health Department No 10

  • Public Health or Welfare Agency
  • White Cloud, MI
  • NPI 1265441877
  NPD (past)

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

{
    "created_epoch": "1451347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601942400000",
    "number": "1760847115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4847 WEST KISTLER ROAD",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "49431",
            "telephone_number": "231-233-1599",
            "fax_number": "616-897-5954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W JOHNSON STREET",
            "city": "HART",
            "state": "MI",
            "postal_code": "49420",
            "telephone_number": "231-873-0586",
            "fax_number": "616-554-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKE",
        "first_name": "JESSE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-29",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801098662",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "L944664",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSE",
            "last_name": "KISTLER",
            "middle_name": "MARIE",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Melissa Borgman, LPTA
• Cheryl Bowen
• Fred Clifford Bowen III
• Douglas S. Brown, D.C.
• Marstie Sue Bunting, D-NP
• James D Burns, PHD
• Kayla Wren Burns, PHARM.D.
• Cherry Blossom Manor, Inc.
• Choices West Counseling Services, Inc
• Samantha Cole, LMT

• Clinical Social Worker in Hart, MI
• Providers in Hart, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2020; 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.