MEDICARE: MELISSA BURKE LMHC

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
2	101YM0800X	Mental Health Counselor	9879	MA

General Provider Information

NPI Number	:	1366652794
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA BURKE LMHC

Provider Business Mailing Address
First Line	:	197 DAVIS ST
Second Line	:
City	:	GREENFIELD
State	:	MA
Zip	:	01301-2526
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	86 WEST ST
Second Line	:
City	:	NEW SALEM
State	:	MA
Zip	:	01355-9723
Country	:	US
Telephone Number	:	413-522-5943
Fax Number	:

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

Provider Enumeration Date	:	05/23/2007
Last Update Date	:	02/05/2020

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