Robert Mason Burdine Jr., LPC
Individual provider Active NPI Professional Counselor · Liberty, SC
NPI 1780007344 · NPPES record last updated Jan 31, 2014
Key facts
- NPI
- 1780007344
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 5635 (SC)
- Practice address
- 314 Springdale Ave
Liberty, SC 29657-3807 - Phone
- (864) 551-0597
- NPI assigned
- Jan 31, 2014
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1 Linwa Blvd
Anderson, SC 29621-4486
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260409000304 | SC | Practitioner - Mental Health Counselor | 0446725212 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5635 | SC | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 5635 | SC | Yes |
Addresses
Primary practice location
314 Springdale Ave
Liberty, SC 29657-3807
Mailing address
314 Springdale Ave
Liberty, SC 29657-3807
Phone (864) 551-0597
Other providers in Liberty, SC
- Baptist Easley Hospital
- Beyond Home Therapy, LLC
- Lorenzo Sentell Black
- Bright Smile Center - Liberty, PA
- Stacy Browder
- Brian Michael Burton
- Cannon Memorial Hospital
- Cannon Memorial Hospital
- Lynn Melton Capobianco
- Sara Lynn Carlstrom
All providers in Liberty, SC · Professional Counselor in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 31, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.