MEDICARE: LAUREN WINDERL 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	007546	NY

General Provider Information

NPI Number	:	1023613924
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN WINDERL LMHC

Provider Business Mailing Address
First Line	:	1062 WEBSTER RD
Second Line	:
City	:	WEBSTER
State	:	NY
Zip	:	14580-9322
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	807 RIDGE RD STE 203
Second Line	:
City	:	WEBSTER
State	:	NY
Zip	:	14580-2497
Country	:	US
Telephone Number	:	585-217-3533
Fax Number	:

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

Provider Enumeration Date	:	12/01/2020
Last Update Date	:	12/01/2020

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