Provider Demographics
NPI:1437458700
Name:BURKHARDT, EVE HELEN (PHD)
Entity Type:Individual
Prefix:DR
First Name:EVE
Middle Name:HELEN
Last Name:BURKHARDT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:EVE
Other - Middle Name:HELEN
Other - Last Name:LAZAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:403 RUSSELL AVE
Mailing Address - Street 2:5G
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877-2819
Mailing Address - Country:US
Mailing Address - Phone:301-216-5837
Mailing Address - Fax:301-216-5834
Practice Address - Street 1:403 RUSSELL AVE
Practice Address - Street 2:5G
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-2819
Practice Address - Country:US
Practice Address - Phone:301-216-5837
Practice Address - Fax:301-216-5834
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-25
Last Update Date:2011-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003787-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical