Active NPI
Ekaterina Victoria Burdo, PSY.D.
- Clinical Psychologist
- Jamaica Plain, MA
National Provider Identifier
1508179094
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 8920
- Practice address
- 170 Morton St
Jamaica Plain, MA 02130-3735 - Phone
- (617) 371-3888
- Fax
- (617) 522-7888
- NPI assigned
- Jul 26, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 8920 | MA | Primary |
Addresses
Primary practice location
170 Morton St
Jamaica Plain, MA 02130-3735
Mailing address
45 Fottler Rd
Apt 3
Mattapan, MA 02126-3140
Phone (617) 849-1033
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8920 | MA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1280102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280102400000",
"number": "1508179094",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "45 FOTTLER RD",
"address_2": "APT 3",
"city": "MATTAPAN",
"state": "MA",
"postal_code": "021263140",
"telephone_number": "617-849-1033",
"fax_number": "617-522-7888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "170 MORTON ST",
"city": "JAMAICA PLAIN",
"state": "MA",
"postal_code": "021303735",
"telephone_number": "617-371-3888",
"fax_number": "617-522-7888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURDO",
"first_name": "EKATERINA",
"middle_name": "VICTORIA",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-07-26",
"last_updated": "2010-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "8920",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jamaica Plain, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.