DR. CHARLES ERNEST BURT (NPI# 1043362197) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1043362197 |
Entity Type | Individual |
Full Name | DR. CHARLES ERNEST BURT |
Credential | PH.D. |
Practice Address |
1800 Michael Faraday Dr Ste 206 Reston VA 20190-5312 |
Mailing Address |
22563 Forest Manor Dr Ashburn VA 20148-6900 |
Practice Telephone | 7038993290 |
Practice Fax Number | 7037239404 |
Mailing Telephone | 7038993290 |
Mailing Fax Number | 7037239404 |
Enumeration Date | 2007-01-17 |
Last Update Date | 2020-02-29 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 103TC0700X |
Psychologist Specialization: Clinical |
0810001508 | VA | Behavioral Health & Social Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
FEDERAL EMPLOYER ID # | 54-1848078 | 01 | |
VA | ANTHEM BXBS RESTON ADDR | 107617 | 01 |
VA | VALUE OPTIONS PROVIDER ID | 031200 | 01 |
Address | Telephone Number | Fax Number |
---|---|---|
21351 Gentry Dr Ste 250, Sterling, VA 201668514 | 7038993290 | 7037239404 |
22563 Forest Manor Dr, Ashburn, VA 201486900 | 7038993290 | 7037239404 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1972792604 | Charles R Burt | Counselor | 3319 N Sheffield Ave Unit 3, Chicago, IL 60657-2293 | 2007-10-18 |
1033243027 | Charles Richard Burt | Dentist | 1175 Franklin St, Rocky Mount, VA 24151-1248 | 2007-03-14 |
1588114482 | Charles Britt Burt | Registered Nurse | Hc 1 Box 8150, Sells, AZ 85634-9737 | 2016-10-04 |
1033466347 | Charles M Burt | Pharmacist | 312 S Main St, Hartford, KY 42347-1129 | 2012-08-07 |
1396032769 | Charles Burt | Counselor | 8745 County Road 9 S, Alamosa, CO 81101-9610 | 2011-07-06 |
1033186309 | Charles F Burt | Orthopaedic Surgery | 2725 S 144th St, #110, Omaha, NE 68144-5243 | 2006-03-04 |
Street Address |
1800 MICHAEL FARADAY DR STE 206 |
City | RESTON |
State | VA |
Zip Code | 20190-5312 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760976633 | Amanda Bales Long | Social Worker | 1800 Michael Faraday Dr Ste 206, Reston, VA 20190-5312 | 2018-06-14 |
1518007640 | Charles E. Burt, Ph.d. and Associates, P.C. | Psychologist | 1800 Michael Faraday Dr Ste 206, Reston, VA 20190-5312 | 2007-02-07 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912548470 | Virginia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1906 Reston Metro Plaza, Suite 100, Reston, VA 20190 | 2019-10-04 |
1205483260 | Northern Virginia Applied Behavior Analysis, L.L.C. | Behavioral Analyst | 1984 Issac Newton Square West, Suite 204, Reston, VA 20190 | 2019-08-23 |
1336796481 | Sandra Chiunda | Nurse Practitioner | 11484 Washington Plaza W 3rd Floor, Reston, VA 20190 | 2019-08-23 |
1891357232 | Beyond Counseling, Inc. | Clinic/Center | 11250 Roger Bacon Dr., Atrium 5, Reston, VA 20190 | 2019-07-06 |
1003470063 | Sarah Katharina Jungnitsch | Registered Nurse | Reston Anesthesia Associates, 11341 Sunset Hills Road, Reston, VA 20190 | 2019-04-25 |
1194202341 | May Health Care Services Inc | Home Health | 12110 Sunset Hills Road Suite 600, Reston, VA 20190 | 2018-07-20 |
1245739895 | Carlee B. Genung | Physician Assistant | 1760 Reston Parkway Suite 306, Reston, VA 20190 | 2018-02-09 |
1760901045 | Kristen Kelly | Dietitian, Registered | 11703 Bowman Green Drive, Lower Level, Reston, VA 20190 | 2017-09-18 |
1245778992 | Sarah Christine Bernstein | Occupational Therapist | 1860 Town Center Drive Ste, Suite 300, Reston, VA 20190 | 2017-02-02 |
1023495298 | Phillip Nguyen | Dentist | 1800 Town Center Dr Ste 116, Reston, VA 20190 | 2015-04-27 |
Find all providers in zip 20190 |
Taxonomy Code | 103TC0700X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Psychologist |
Specialization | Clinical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275916413 | Claudia Patricia Amendola | Psychologist | 1818 Library St Ste 567, Reston, VA 20190-6242 | 2015-07-07 |
1578970224 | Lauren King Wall | Psychologist | 1810 Michael Faraday Dr Ste 204, Reston, VA 20190-5330 | 2014-07-15 |
1144505082 | Abram Sterne | Psychologist | 11150 Sunset Hills Road, Suite 150, Family Compass, Reston, VA 20190 | 2011-10-11 |
1568741841 | Tara Luv Travia | Psychologist | 11250 Roger Bacon Dr Ste 2, Reston, VA 20190-5202 | 2011-08-04 |
1083751648 | Linda Rose Goglia | Psychologist | 11333 Sunset Hills Road, Linda R Goglia Phd, Reston, VA 20190-5205 | 2007-01-31 |
1952467664 | Carlos Durana | Psychologist | 11417 Tanbark Dr, Reston, VA 20191-4103 | 2006-12-28 |
1932269339 | Mary Jo Smrekar | Psychologist | 11231 Handlebar Rd, Reston, VA 20191-3907 | 2006-12-08 |
1962578195 | Robert P. Rugel | Psychologist | 11506 Purple Beech Dr, Reston, VA 20191-1328 | 2006-11-28 |
1225148976 | Sarita Bobrick Kaplan | Psychologist | 11333 Sunset Hill Road, Reston, VA 20190-5205 | 2006-08-30 |
1881674885 | Bruce V Corsino | Psychologist | 12166 Chancery Station Cir, Reston, VA 20190-5803 | 2006-01-18 |
Find all providers in RESTON |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.