Provider Demographics
NPI:1528141579
Name:BURPEE, MARGARITA S (RN, LICSW)
Entity type:Individual
Prefix:MRS
First Name:MARGARITA
Middle Name:S
Last Name:BURPEE
Suffix:
Gender:F
Credentials:RN, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 ELM STREET
Mailing Address - Street 2:P.O. BOX 345
Mailing Address - City:KINGSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02364-0345
Mailing Address - Country:US
Mailing Address - Phone:781-936-8068
Mailing Address - Fax:781-936-8286
Practice Address - Street 1:4 ELM ST
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:MA
Practice Address - Zip Code:02364-1906
Practice Address - Country:US
Practice Address - Phone:781-936-8068
Practice Address - Fax:781-936-8268
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2009-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1131721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MABU-P23951Medicare ID - Type Unspecified