Keith Yale Burger, LISW-LPCC
Individual provider Active NPI Clinical Social Worker · Cortland, OH
NPI 1972591998 · NPPES record last updated Aug 14, 2012
Key facts
- NPI
- 1972591998
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- OH I0000401 (OH)
- Practice address
- 197 W Main St
Cortland, OH 44410-1460 - Phone
- (330) 856-6640
- NPI assigned
- Oct 13, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 1972
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Specialty Care Counseling Services LTD
Practice addresses (Care Compare)
2000 E Market St
Warren, OH 44483-6156
Phone (330) 393-5566
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- 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 |
|---|---|---|---|---|
| I20061213000037 | OH | Practitioner - Clinical Social Worker | 5698774081 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OH E0000169 | OH | MD | Professional Counselor |
| I0000401 | OH | MD | Clinical Social Worker |
| OH I0000401 | OH | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Specialty Care Counseling Services, LTD | Current |
Accepting new patients | |
| Specialty Care Counseling Services, LTD | Current |
Accepting new patients |
Locations
2000 E Market St
Warren, OH 44483
Phone (330) 393-5566
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | OH E0000169 | OH | |
| Clinical Social Worker | 1041C0700X | OH I0000401 | OH | Yes |
Addresses
Primary practice location
197 W Main St
Cortland, OH 44410-1460
Mailing address
197 W Main St
Cortland, OH 44410-1460
Phone (330) 856-6640
Other names
- Mr. Keith Yale Burger
Other providers in Cortland, OH
- Anna Brewer
- James R Brown
- Christine L Brunko
- David Alan Brys
- Elyse Bryson
- Melissa Busefink
- Aaron Christopher Bush
- Lori Ann Bush
- Andre J Camelli
- Cheryl Ann Cigoy
All providers in Cortland, OH · Clinical Social Worker in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 14, 2012. 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.