KELLY J BURG LCSW,SAC - NPI 1639421373 - Counselor in Lac Du Flambeau, WI

Q: What is Kelly Burg's NPI number?

The NPI number for Kelly Burg is 1639421373. It was assigned to this individual provider in the NPPES registry on October 4, 2012. The provider is also known as Kelly J Day Lcsw.

Q: What is Kelly Burg's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Burg was last updated on April 22, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Kelly J Burg Lcsw,sac NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY J BURG LCSW,SAC (NPI 1639421373) is an individual mental health provider in Lac Du Flambeau, Wisconsin, licensed in Wisconsin (8996-123) and active in the NPI registry since October 2012. She is enrolled in Medicare PECOS and is a graduate of Other (2013).

NPPES Registry Identity

NPI1639421373

Entity TypeIndividualFemale

Primary Taxonomy101YM0800X

Provider Legal NameKELLY J BURGCredential: LCSW,SAC

Location Address533 PEACE PIPE ROADLac Du Flambeau, WI 54538-0189

Mailing Address1030 Phillips PlSaint Germain, WI 54558-9713 · (715) 588-1511 · Fax (715) 588-3903

Phone(715) 588-1511

Fax(715) 588-3903

Sole ProprietorNo

Medical School CMSOtherGraduated 2013

Enumeration DateOctober 4, 2012

Last NPPES UpdateApril 22, 20262 updates tracked since enumeration

NPPES CertifiedApril 22, 2026

✔ NPI 1639421373 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

License✔ Licensed in WI · 8996-123

Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 15508-131 (WI)

533 PEACE PIPE ROAD, Lac Du Flambeau, WI 54538

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Other Names 1

Former Name (1)Kelly J Day Lcsw

Other Identifiers 1

Medicaid1639421373WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Aspirus Health Plan, Medica, Network Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kelly J Burg Lcsw,sac is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6103287008

PECOS Enrollment IDI20230725001492

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. PATRICK DAY RADC1

Counselor (Addiction (Substance Use Disorder))