Burt, Charles Ernest

Burt, Charles Ernest is an individual health care provider with primary practice located at 1800 Michael Faraday Dr Ste 206 , Reston VA 20190-5312. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Burt, Charles Ernest can be contacted via phone (703) 899-3290.

Contact Information

Primary practice address
1800 Michael Faraday Dr Ste 206 Reston VA 20190-5312
Phone: (703) 899-3290
Fax: (703) 723-9404
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 0810001508 Virginia

Profile Details

NPI number 1043362197
LBN Legal business name Burt, Charles Ernest
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 17th, 2007
Last updated Feb 29th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043362197 NPPES
Virginia Other 031200 VALUE OPTIONS PROVIDER ID
Virginia Other 107617 VALUE OPTIONS PROVIDER ID
Virginia Other 54-1848078 VALUE OPTIONS PROVIDER ID

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