Provider Demographics
NPI:1841601630
Name:BURT, ROBYN L (LPC, LCADC)
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:L
Last Name:BURT
Suffix:
Gender:F
Credentials:LPC, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 ALTAIR CT
Mailing Address - Street 2:
Mailing Address - City:TURNERSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08012-2406
Mailing Address - Country:US
Mailing Address - Phone:856-582-1419
Mailing Address - Fax:856-582-7661
Practice Address - Street 1:65 COOPER ST
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NJ
Practice Address - Zip Code:08096-4646
Practice Address - Country:US
Practice Address - Phone:856-818-3558
Practice Address - Fax:856-589-8239
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-14
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00665100101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional