Individual provider Active NPI

Scott Andrew Burke, LCSW

  • Clinical Social Worker
  • Coeur D Alene, ID
National Provider Identifier
1972996924
Registry record updated Jul 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
296 W. Sunset Ave
Ste 15
Coeur D Alene, ID 83815-8366
Phone
(208) 666-0357
Fax
(208) 666-0468
NPI assigned
Mar 16, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LMSW-29199 ID
Social Worker 104100000X
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

296 W. Sunset Ave
Ste 15
Coeur D Alene, ID 83815-8366

Mailing address

296 W. Sunset Ave
Ste 15
Coeur D Alene, ID 83815-8366
Phone (208) 666-0357

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMSW-29199IDMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Dirne Health Centers Inc Mental Health PastSince Mar 1, 2021 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1426464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1972996924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "296 W. SUNSET AVE",
            "address_2": "STE 15",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838158366",
            "telephone_number": "208-666-0357",
            "fax_number": "208-666-0468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "296 W. SUNSET AVE",
            "address_2": "STE 15",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838158366",
            "telephone_number": "208-666-0357",
            "fax_number": "208-666-0468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKE",
        "first_name": "SCOTT",
        "middle_name": "ANDREW",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-16",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LMSW-29199",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coeur D Alene, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; 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.