Provider Demographics
NPI:1124040662
Name:BURTON, MELISSA J (MS, LMHC)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:J
Last Name:BURTON
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47804-2771
Mailing Address - Country:US
Mailing Address - Phone:812-231-8323
Mailing Address - Fax:
Practice Address - Street 1:500 8TH AVE
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47804-4072
Practice Address - Country:US
Practice Address - Phone:812-242-2244
Practice Address - Fax:812-231-8208
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39001543A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health