MEDICARE: MS. MADISON KAMALANI BURKOTT LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	92204	TX
2	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1134797020
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MADISON KAMALANI BURKOTT LPC

Provider Business Mailing Address
First Line	:	5460 PAREDES LINE RD STE 206
Second Line	:
City	:	BROWNSVILLE
State	:	TX
Zip	:	78526-9741
Country	:	US
Telephone Number	:	956-410-2424
Fax Number	:

Provider Business Practice Location Address
First Line	:	5460 PAREDES LINE RD STE 206
Second Line	:
City	:	BROWNSVILLE
State	:	TX
Zip	:	78526-9741
Country	:	US
Telephone Number	:	956-410-2424
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2021
Last Update Date	:	02/19/2025

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