KELLY J BURG (LCSW,SAC) – Mental Health Counselor, NPI 1639421373
Mental Health Counselor
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,447 CLINICAL SOCIAL WORKER in WI
Provider Addresses for KELLY J BURG (LCSW,SAC)
15501 INDIAN VILLAGE RD
LAC DU FLAMBEAU, WI 545381178
Phone: (715) 369-7300
Fax: (715) 369-7301
Type: Mailing
1030 PHILLIPS PL
SAINT GERMAIN, WI 545589713
Phone: (715) 588-1511
Fax: (715) 588-3903
Type: Mailing
533 PEACE PIPE ROAD
LAC DU FLAMBEAU, WI 545380189
Phone: (715) 588-1511
Fax: (715) 588-3903
Type: Location
158 S Anderson St
Suite 3
Rhinelander, WI 545013447
Phone: (715) 369-7300
Fax: (715) 369-7300
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: 2023-07-25
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20230725001492 | I | Clinical Social Worker | WI | TBD |
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.
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 54538)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Clinical Social Worker | WI | |
| Physical Therapist In Private Practice | WI | |
| P O D I A T R Y | WI | |
| Infectious Disease, Internal Medicine | WI | |
| Physical Medicine And Rehabilitation | WI | |
| Physician Assistant | WI | |
| Mental Health Counselor | WI | |
| Nurse Practitioner | WI | |
| Nurse Practitioner | WI | |
| - | WI |
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