Shauna Burgess, LICSW
Individual provider Active NPI Mental Health Counselor · Exeter, NH
NPI 1902902950 · NPPES record last updated Oct 1, 2019
Key facts
- NPI
- 1902902950
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 1327 (NH)
- Practice address
- 24 Front St Ste 406
Exeter, NH 03833 - Phone
- (617) 306-0610
- Fax
- (617) 337-4412
- NPI assigned
- Sep 16, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
24 Front St
Exeter, NH 03833-2727
Phone (617) 306-0610
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NH
- 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 |
|---|---|---|---|---|
| I20190522002705 | NH | Practitioner - Clinical Social Worker | 8628075819 | Practice locations: Exeter, NH |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1327 | NH | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northeast Health Services, LLC | Past |
Accepting new patients |
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 110871 | MA | |
| Clinical Social Worker | 1041C0700X | |||
| Mental Health Counselor | 101YM0800X | 1327 | NH | Yes |
Addresses
Primary practice location
24 Front St Ste 406
Exeter, NH 03833
Mailing address
24 Front St Ste 406
Exeter, NH 03833-2727
Phone (617) 306-0610
Other practice location 1
110 Haverhill Rd
Ste 214
Amesbury, MA 01913-2137
Phone (617) 306-0610
Other practice location 2
24 Front St Ste 406
Exeter, NH 03833
Phone (617) 306-0610
Other providers in Exeter, NH
- Francis Bruskey
- April Buchanan Cain
- Elizabeth Ann Buchanan
- Christopher Buchart
- Hilary Mae Buotte
- Robin Burns
- Sean Burns
- Sean Alexander Buturla
- Kelsey L Byron
- Chad M. Cabral
All providers in Exeter, NH · Mental Health Counselor in New Hampshire
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 1, 2019. 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.