Provider Demographics
NPI:1134797020
Name:BURKOTT, MADISON KAMALANI (LPC)
Entity type:Individual
Prefix:MS
First Name:MADISON
Middle Name:KAMALANI
Last Name:BURKOTT
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5460 PAREDES LINE RD STE 206
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78526-9741
Mailing Address - Country:US
Mailing Address - Phone:956-410-2424
Mailing Address - Fax:
Practice Address - Street 1:5460 PAREDES LINE RD STE 206
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78526-9741
Practice Address - Country:US
Practice Address - Phone:956-410-2424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-16
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX92204101Y00000X
106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician