Charles R Burt, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180007553 Issued in IL

Practice address

3319 N Sheffield Ave Unit 3
Chicago, IL 60657-2293

Phone

(773) 429-9454

Fax

(866) 897-4573

NPI assigned

Oct 18, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Chrysalis Counseling Group PLLC

  • Mental Health Counselor
  • Chicago, IL
  • NPI 1659078186
  NPD Authorized official
• Chrysalis Counseling Group

  • Professional Counselor
  • Chicago, IL
  • NPI 1407149693

  Professional

  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1192665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286323200000",
    "number": "1972792604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3319 N SHEFFIELD AVE UNIT 3",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606572293",
            "telephone_number": "773-429-9454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3319 N SHEFFIELD AVE UNIT 3",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606572293",
            "telephone_number": "773-429-9454",
            "fax_number": "866-897-4573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURT",
        "first_name": "CHARLES",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-18",
        "last_updated": "2010-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180007553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Scott Burstein, M.D.
• Adam J Bursua, PHARM.D.
• Vika Ona Bursua, PHARM.D., CACP
• Emily Bursuck
• Cassaundra Burt, MD
• Leah Susanne Burt, A.P.N.
• Noel Marissa Burt, PT, DPT
• Burtaine Counseling, LTD
• Kristin Lee Burtaine, MA, LCPC
• Burton Homes Community Outreach NFP

• All providers in Chicago, IL
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 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.

Verify at the official NPI Registry.