MEDICARE: WENDY A LEVY 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	LC1354	MD

General Provider Information

NPI Number	:	1972615276
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WENDY A LEVY LCPC

Provider Business Mailing Address
First Line	:	172 THOMAS JOHNSON DR STE 204
Second Line	:
City	:	FREDERICK
State	:	MD
Zip	:	21702-4404
Country	:	US
Telephone Number	:	301-663-8343
Fax Number	:	301-695-0746

Provider Business Practice Location Address
First Line	:	172 THOMAS JOHNSON DR STE 204
Second Line	:
City	:	FREDERICK
State	:	MD
Zip	:	21702-4404
Country	:	US
Telephone Number	:	301-663-8343
Fax Number	:	301-695-0746

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	07/08/2007

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Directions to “ WENDY A LEVY LCPC” Practice Location

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