Provider Demographics
NPI:1518590249
Name:BURTON, JOSHUA ROSS (LPC)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:ROSS
Last Name:BURTON
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1117 WISSAHICKON AVE
Mailing Address - Street 2:
Mailing Address - City:PENLLYN
Mailing Address - State:PA
Mailing Address - Zip Code:19422-1032
Mailing Address - Country:US
Mailing Address - Phone:814-933-2763
Mailing Address - Fax:
Practice Address - Street 1:835 OLD YORK RD
Practice Address - Street 2:
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-1601
Practice Address - Country:US
Practice Address - Phone:215-886-2923
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-21
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC009957101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional