Physician Compare National (NPI:1912228867)

HEALTHCARE PROVIDER: KIM BURKLAND-WARD LICSW

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1912228867
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7810209475
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20150710000118
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BURKLAND-WARD
	Individual professional last name
Provider First Name	KIM
	Individual professional first name
Provider Middle Name	MARIE
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	BOSTON UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2012
	Individual professional's medical school graduation year
Primary Specialty	CLINICAL SOCIAL WORKER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	154 BROAD ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 1527
	Group Practice or individual's line 2 address
City	NASHUA
	Group Practice or individual's city
State	NH
	Group Practice or individual's state
Zip Code	030633205
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y