MEDICARE: MR. JEFFREY YEHUDA SHINENSKY LCPC

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	101YP2500X	Professional Counselor	LC2781	MD

General Provider Information

NPI Number	:	1194997676
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JEFFREY YEHUDA SHINENSKY LCPC

Provider Business Mailing Address
First Line	:	1111 UNIVERSITY BLVD W
Second Line	:	APT 103
City	:	SILVER SPRING
State	:	MD
Zip	:	20902-3351
Country	:	US
Telephone Number	:	301-801-4405
Fax Number	:

Provider Business Practice Location Address
First Line	:	1111 UNIVERSITY BLVD W
Second Line	:	APT 103
City	:	SILVER SPRING
State	:	MD
Zip	:	20902-3351
Country	:	US
Telephone Number	:	301-801-4405
Fax Number	:

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

Provider Enumeration Date	:	03/25/2008
Last Update Date	:	06/12/2008

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