MEDICARE: MR. JOHN P GIORGIO M.S, LMHC, 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	101Y00000X	Counselor	LPC7104	SD

General Provider Information

NPI Number	:	1740416361
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHN P GIORGIO M.S, LMHC, LPC

Provider Business Mailing Address
First Line	:	204 E. MAIN ST
Second Line	:	PO BOX 798
City	:	ELK POINT
State	:	SD
Zip	:	57025-0798
Country	:	US
Telephone Number	:	605-356-3317
Fax Number	:	605-356-2721

Provider Business Practice Location Address
First Line	:	204 E. MAIN ST
Second Line	:
City	:	ELK POINT
State	:	SD
Zip	:	57025-0798
Country	:	US
Telephone Number	:	605-356-3317
Fax Number	:	605-356-2721

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

Provider Enumeration Date	:	06/10/2009
Last Update Date	:	06/10/2009

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