MR. MICHAEL JAY BURKETT PC LICDC NPI 1861776023

NPI Information

NPI: 1861776023
Provider Name: MR. MICHAEL JAY BURKETT, PC, LICDC
Classification: Counselor - 101YP2500X
Entity Type: Individual

Specialization: Professional

Address:
611 BELMONT AVE
YOUNGSTOWN, OH
ZIP 44502
Phone: (330) 744-2991
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MR. Michael Jay Burkett, PC, LICDC is a professional counselor in Youngstown, OH. MR. Michael Jay Burkett, PC, LICDC NPI is 1861776023. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

611 BELMONT AVE
YOUNGSTOWN, OH
ZIP 44502-037
Phone: (330) 744-2991

The enumeration date for this NPI number is 10/6/2011 and was last updated on 10/6/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	071005	OHIO	No
2	101YP2500X	Counselor	Professional	C 0600591	OHIO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0241705	MEDICAID	OHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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