MEDICARE: JOSEPH MATHEW BURTON 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	101YM0800X	Mental Health Counselor	18980	FL

General Provider Information

NPI Number	:	1629631742
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH MATHEW BURTON LMHC

Provider Business Mailing Address
First Line	:	2755 N WICKHAM RD STE 102
Second Line	:
City	:	MELBOURNE
State	:	FL
Zip	:	32935-2226
Country	:	US
Telephone Number	:	321-241-4861
Fax Number	:	321-306-2793

Provider Business Practice Location Address
First Line	:	2755 N WICKHAM RD STE 102
Second Line	:
City	:	MELBOURNE
State	:	FL
Zip	:	32935-2226
Country	:	US
Telephone Number	:	321-241-4861
Fax Number	:	321-306-2793

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

Provider Enumeration Date	:	04/15/2019
Last Update Date	:	02/02/2026

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