Andrea Burgess, LCSW
Individual provider Active NPI Clinical Social Worker · Swannanoa, NC
NPI 1942533807 · NPPES record last updated Jul 14, 2021
Key facts
- NPI
- 1942533807
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- C006921 (NC)
- Practice address
- 105 Lanier Lane
Swannanoa, NC 28778 - Phone
- (828) 337-8468
- Fax
- (828) 338-5099
- NPI assigned
- Sep 10, 2009
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231213000192 | NM | Practitioner - Clinical Social Worker | 6901059849 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C006921 | NC | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Presbyterian Healthcare Services | Current |
Accepting new patients | |
| Presbyterian Healthcare Services | Current |
Accepting new patients | |
| Harmony Through Horses PLLC | Clinical | Current |
Accepting new patients |
| Medlink Management Services Inc | Past | Accepting new patients | |
| Universal Mental Health Services, Inc | Past | Accepting new patients |
Locations
4588 Paradise Blvd NW
Albuquerque, NM 87114
Phone (505) 923-2070
2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577
1010 Spruce St
Espanola, NM 87532
Phone (505) 367-0340
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | C006921 | NC | Yes |
Addresses
Primary practice location
105 Lanier Lane
Swannanoa, NC 28778
Mailing address
203 Hawthorne Ave
Swannanoa, NC 28778-2421
Phone (828) 337-8468
Other providers in Swannanoa, NC
- Bee Tree Counseling PLLC
- Lucinda Bickers
- Kimberly Ann Black
- Bluewest Opportunities, Inc.
- Richard O'Neil Boucher
- Leigh Manuel Coffey
- Brett Michael Comeau
- Shannon Martin Coney
- Emily Kara Cox
- Donald Jason Curto
All providers in Swannanoa, NC · Clinical Social Worker in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 14, 2021. 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).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.