Elaine Formica Burnham, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

000698 Issued in CT

Practice address

378 Long Hill Rd
South Windsor, CT 06074-4217

Phone

(860) 528-7005

NPI assigned

Jan 23, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 1996

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1201046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201046400000",
    "number": "1881871606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "378 LONG HILL RD",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060744217",
            "telephone_number": "860-528-7005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "378 LONG HILL RD",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060744217",
            "telephone_number": "860-528-7005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORMICA BURNHAM",
        "first_name": "ELAINE",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-23",
        "last_updated": "2008-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "000698",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LPC",
            "identifier": "00698",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa D Fiasconaro
• Charles Lawrence Field, PH.D.
• Jane Marion Finston, PT
• Helen Hahn Fisher, M.S.
• Robert Fogel, LMFT
• Krystal Fortin, LCSW
• Kathleen Fox, M.S., SLP-CCC
• Maureen A Francis-Dunn, LCSW
• Eileen Freedman, M.D.
• Matthew Friedman, M.D.

• Professional Counselor in South Windsor, CT
• Providers in South Windsor, CT by specialty
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.