Provider Demographics
NPI:1205712866
Name:BURDICK, JESSICA LYNNE
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:LYNNE
Last Name:BURDICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 SPRING ST APT C
Mailing Address - Street 2:
Mailing Address - City:ADAMS
Mailing Address - State:MA
Mailing Address - Zip Code:01220-2257
Mailing Address - Country:US
Mailing Address - Phone:413-652-0013
Mailing Address - Fax:
Practice Address - Street 1:25 SPRING ST APT C
Practice Address - Street 2:
Practice Address - City:ADAMS
Practice Address - State:MA
Practice Address - Zip Code:01220-2257
Practice Address - Country:US
Practice Address - Phone:413-652-0013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst