MEDICARE: MRS. BARET MELTON 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	13216	FL

General Provider Information

NPI Number	:	1881934545
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BARET MELTON LMHC

Provider Business Mailing Address
First Line	:	3024 FAIRWAY LN
Second Line	:	APARTMENT B
City	:	ORLANDO
State	:	FL
Zip	:	32804-3745
Country	:	US
Telephone Number	:	251-463-4132
Fax Number	:

Provider Business Practice Location Address
First Line	:	5749 WESTGATE DR
Second Line	:	SUITE 102
City	:	ORLANDO
State	:	FL
Zip	:	32835-5040
Country	:	US
Telephone Number	:	407-558-0584
Fax Number	:

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

Provider Enumeration Date	:	02/18/2013
Last Update Date	:	04/30/2015

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