MEDICARE: ADAM WALLACE LENKER LPC

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	68766	TX
2	101YP2500X	Professional Counselor	10272125	WI

General Provider Information

NPI Number	:	1508291188
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADAM WALLACE LENKER LPC

Provider Business Mailing Address
First Line	:	440 SCIENCE DR STE 300
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53711-1064
Country	:	US
Telephone Number	:	608-236-4460
Fax Number	:

Provider Business Practice Location Address
First Line	:	440 SCIENCE DR STE 300
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53711-1064
Country	:	US
Telephone Number	:	608-236-4460
Fax Number	:

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

Provider Enumeration Date	:	09/13/2013
Last Update Date	:	03/06/2023

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