AMICA A BURKETT-ROSSER (MSE, LPCC) – Mental Health Counselor, NPI 1619496825

AMICA A BURKETT-ROSSER (MSE, LPCC) is a healthcare provider. based in Canton, Ohio. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials MSE, LPCC. They hold a License No. E2102651 (OH). The NPI Number for AMICA A BURKETT-ROSSER (MSE, LPCC) is 1619496825

Main info

Female
11 Years Of Experience
Accepts Medicare Assignment
Name
AMICA A BURKETT-ROSSER (MSE, LPCC)
NPI
1619496825
Phone
(330) 433-6075
Address
4641 FULTON DR NW
Enumeration Date
19 September 2017
Last Update Date
10 May 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3307625425
Graduation Year
2015 (11 years ago)
PAC ID
5496107419
Group Practice PAC ID
6709771843
Professional Enrollment ID
I20240116001140
Address ID
OH443031413AK640XXSTXX400
Data current as of
3 June 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness85
Years active:8State licenses:1Digital endpointsOther names

2,538 MENTAL HEALTH COUNSELOR in OH

Provider Addresses for AMICA A BURKETT-ROSSER (MSE, LPCC)

  • 4641 FULTON DR NW

    CANTON, OH 447182384

    Phone: (330) 433-6075

    Type: Location

  • 4641 Fulton Dr NW

    Canton, OH 447182384

    Phone: (330) 433-6075

    Type: Location

  • 1024, Dan Street, Forest Hill, Cascade Valley, Akron, Summit County, Ohio, 44310, United States

    AKRON, OH 443103441

    Phone: (330) 524-5296

    Type: Mailing

  • 274 WHITE POND DR

    AKRON, OH 443201118

    Phone: (330) 762-5425

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-01-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240116001140IMental Health CounselorOHTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 44718)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6709771843View full group profile
NameSpecialtyState
Clinical Social WorkerOH
-OH
Physical Therapist In Private PracticeOH
Clinical Social WorkerOH
-OH
Mental Health CounselorOH
Clinical Social WorkerOH
Gastroenterology, Internal MedicineOH
Clinical PsychologistOH
Clinical Social WorkerOH

Reviews

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Frequently asked questions

What federal number belongs to AMICA A BURKETT-ROSSER (MSE, LPCC)?
The federal identifier for AMICA A BURKETT-ROSSER (MSE, LPCC) is NPI 1619496825.
Is AMICA A BURKETT-ROSSER (MSE, LPCC)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What kind of provider is AMICA A BURKETT-ROSSER (MSE, LPCC)?
The page reflects Mental Health Counselor for AMICA A BURKETT-ROSSER (MSE, LPCC). Clinical services aligned with this taxonomy classification.
What location shows for AMICA A BURKETT-ROSSER (MSE, LPCC)?
We surface Canton, Ohio for AMICA A BURKETT-ROSSER (MSE, LPCC) based on available NPPES addresses.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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