MEDICARE: JONATHAN VALLETTA MA, RMHCI

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	101YM0800X	Mental Health Counselor	13700	FL

General Provider Information

NPI Number	:	1376071910
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JONATHAN VALLETTA MA, RMHCI

Provider Business Mailing Address
First Line	:	983 VILLA DR
Second Line	:
City	:	MELBOURNE
State	:	FL
Zip	:	32940-7072
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	880 AIRPORT BLVD
Second Line	:
City	:	MELBOURNE
State	:	FL
Zip	:	32901-2909
Country	:	US
Telephone Number	:	321-914-0612
Fax Number	:

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

Provider Enumeration Date	:	05/26/2017
Last Update Date	:	03/31/2026

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