Provider Demographics
NPI:1205984929
Name:BURKETT, LORI A (CLINICAL PSYCHOLOGIS)
Entity type:Individual
Prefix:DR
First Name:LORI
Middle Name:A
Last Name:BURKETT
Suffix:
Gender:
Credentials:CLINICAL PSYCHOLOGIS
Other - Prefix:
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Mailing Address - Street 1:5268 GODWIN BLVD
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-8114
Mailing Address - Country:US
Mailing Address - Phone:757-255-7117
Mailing Address - Fax:757-255-7139
Practice Address - Street 1:135 S SARATOGA ST
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-5322
Practice Address - Country:US
Practice Address - Phone:757-255-7117
Practice Address - Fax:757-255-7139
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0810003752103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical