Jennifer Renee Burleson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

11575-C Issued in AR

Practice address

1116 S Walton Blvd Ste 114
Bentonville, AR 72712-6126

Phone

(479) 309-1973

NPI assigned

Apr 1, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other names 1

• Jennifer Vanden Bosch Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Jennifer Burleson LCSW, PLLC

  • Clinical Social Worker
  • Bentonville, AR
  • NPI 1033852678
  NPD Authorized official
• South Orange Blossoms, LLC

  • Clinical Social Worker
  • Summit, NJ
  • NPI 1063985679
  NPD Authorized official

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

{
    "created_epoch": "1301616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651622400000",
    "number": "1881983633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5215 S BROOKMERE ST",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727585097",
            "telephone_number": "917-405-5514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1116 S WALTON BLVD STE 114",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727126126",
            "telephone_number": "479-309-1973"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "467 Springfield Ave Ste 205",
            "address_purpose": "LOCATION",
            "city": "Summit",
            "state": "NJ",
            "postal_code": "079012622",
            "country_code": "US",
            "telephone_number": "973-370-5686",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURLESON",
        "first_name": "JENNIFER",
        "middle_name": "RENEE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-01",
        "last_updated": "2022-05-04",
        "certification_date": "2022-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "078868",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05697100",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "11575-C",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "076703",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "VANDEN BOSCH",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jorden Burgess
• Kaitlin Burgess
• Joshua Burk
• Tyler Burks
• Ellen Ann Burleson, MHPP
• Kristen Burns, PT
• James D Burrow, MD
• Leah Elizabeth Burry, COTAL
• Katelyn Burt
• Chelsey Lee Burton, PA-C, EM-CAQ

• Clinical Social Worker in Bentonville, AR
• Providers in Bentonville, AR by specialty
• Clinical Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2022; 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.