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NPI Code Detail

MEDICARE: REBECCA J BURDA LCSW

MEDICARE: REBECCA J BURDA LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker8958-123WI
21041C0700XClinical Social Worker9503TN
31041C0700XClinical Social Worker34034MN
41041C0700XClinical Social Worker149.030026IL
51041C0700XClinical Social WorkerSWB-2026-0389NM

General Provider Information

NPI Number : 1679030894
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA J BURDA LCSW
Provider Business Mailing Address
First Line : 739 MEADOW CT
Second Line :
City : TWIN LAKES
State : WI
Zip : 53181-9180
Country : US
Telephone Number : 616-540-2236
Fax Number :
Provider Business Practice Location Address
First Line : 3536 52ND ST
Second Line :
City : KENOSHA
State : WI
Zip : 53144-2662
Country : US
Telephone Number : 262-764-8555
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/24/2019
Last Update Date : 04/17/2026

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Directions to “ REBECCA J BURDA LCSW” Practice Location

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