Active NPI
Judith Burnett, PHD
- Clinical Psychologist
- Winter Park, FL
National Provider Identifier
1629608567
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY5947
- Practice address
- 5901 Brick CT
Winter Park, FL 32792-9392 - Phone
- (407) 716-2921
- NPI assigned
- Jan 20, 2020
- Last updated
- Jan 20, 2020
- 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 | PY5947 | FL | Primary |
Addresses
Primary practice location
5901 Brick CT
Winter Park, FL 32792-9392
Mailing address
2857 Aloma Lake Run
Oviedo, FL 32765-7390
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY5947 | FL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1579478400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579478400000",
"number": "1629608567",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2857 ALOMA LAKE RUN",
"city": "OVIEDO",
"state": "FL",
"postal_code": "327657390"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5901 BRICK CT",
"city": "WINTER PARK",
"state": "FL",
"postal_code": "327929392",
"telephone_number": "407-716-2921"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURNETT",
"first_name": "JUDITH",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-01-20",
"last_updated": "2020-01-20",
"certification_date": "2020-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "FL",
"license": "PY5947",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winter Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.