Provider Demographics
NPI:1407109861
Name:BURT, BARBARA CUMMINGS (PSYD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:CUMMINGS
Last Name:BURT
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:335 FOOTHILLS SOUTH DR
Mailing Address - Street 2:
Mailing Address - City:SEDONA
Mailing Address - State:AZ
Mailing Address - Zip Code:86336-5027
Mailing Address - Country:US
Mailing Address - Phone:619-729-7791
Mailing Address - Fax:619-764-4020
Practice Address - Street 1:335 FOOTHILLS SOUTH DR
Practice Address - Street 2:
Practice Address - City:SEDONA
Practice Address - State:AZ
Practice Address - Zip Code:86336-5027
Practice Address - Country:US
Practice Address - Phone:619-729-7791
Practice Address - Fax:619-764-4020
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-23
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY23977103T00000X, 103TC0700X
AZPSY5321103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist