MEDICARE: JILL MARIE KRAHWINKEL 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	7473	NC
2	101YM0800X	Mental Health Counselor	7473	NC
3	101YP2500X	Professional Counselor	7473	NC

General Provider Information

NPI Number	:	1790916328
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JILL MARIE KRAHWINKEL LPC

Provider Business Mailing Address
First Line	:	1001 LIMERICK LN
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27713-2390
Country	:	US
Telephone Number	:	270-929-9080
Fax Number	:

Provider Business Practice Location Address
First Line	:	1001 LIMERICK LN
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27713-2390
Country	:	US
Telephone Number	:	270-929-9080
Fax Number	:

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

Provider Enumeration Date	:	07/30/2009
Last Update Date	:	10/26/2009

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