Individual
DR. CHARLES ERNEST BURT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1800 MICHAEL FARADAY DR STE 206, RESTON, VA 20190-5312
(703) 899-3290
(703) 723-9404
Mailing address
22563 FOREST MANOR DR, ASHBURN, VA 20148-6900
(703) 899-3290
(703) 723-9404
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810001508
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
031200
VALUE OPTIONS PROVIDER ID
VA
01
—
107617
ANTHEM BXBS RESTON ADDR
VA
01
—
54-1848078
FEDERAL EMPLOYER ID #
—
Enumeration date
01/17/2007
Last updated
02/29/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us