MEDICARE: MARTHA GRACE BURTON

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	ALC04503	AL

General Provider Information

NPI Number	:	1861176901
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARTHA GRACE BURTON

Provider Business Mailing Address
First Line	:	560 WOODMERE CREEK WAY
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35226-3569
Country	:	US
Telephone Number	:	502-794-1047
Fax Number	:

Provider Business Practice Location Address
First Line	:	4 OFFICE PARK CIR STE 306
Second Line	:
City	:	MOUNTAIN BRK
State	:	AL
Zip	:	35223-2692
Country	:	US
Telephone Number	:	205-730-6570
Fax Number	:

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

Provider Enumeration Date	:	06/09/2023
Last Update Date	:	12/09/2025

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Directions to “ MARTHA GRACE BURTON ” Practice Location

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