MEDICARE: SANDRA L CHMIELEWSKI 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	101YP2500X	Professional Counselor	MH25382	FL

General Provider Information

NPI Number	:	1366244931
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA L CHMIELEWSKI LMHC

Provider Business Mailing Address
First Line	:	20517 GRAND VISTA LN
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-3456
Country	:	US
Telephone Number	:	952-412-4985
Fax Number	:

Provider Business Practice Location Address
First Line	:	2406 CYPRESS GLEN DR STE 101
Second Line	:
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33544-4609
Country	:	US
Telephone Number	:	813-710-4307
Fax Number	:

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

Provider Enumeration Date	:	03/25/2025
Last Update Date	:	03/25/2025

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