Provider Demographics
NPI:1427416775
Name:BURT, SHERRI (MFT)
Entity Type:Individual
Prefix:
First Name:SHERRI
Middle Name:
Last Name:BURT
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:SHERRI
Other - Middle Name:MARIE
Other - Last Name:BURT-SCHOEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MFT
Mailing Address - Street 1:2239 TOWNSGATE RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361
Mailing Address - Country:US
Mailing Address - Phone:805-418-5334
Mailing Address - Fax:805-418-5334
Practice Address - Street 1:2239 TOWNSGATE RD
Practice Address - Street 2:SUITE 108
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-2405
Practice Address - Country:US
Practice Address - Phone:805-418-5334
Practice Address - Fax:805-418-5334
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-02
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54036106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist