MEDICARE: MRS. ANTOINLETE CHEREF PENNYCOOKE MA, 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	101YM0800X	Mental Health Counselor	MH 9440	FL

General Provider Information

NPI Number	:	1174690663
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANTOINLETE CHEREF PENNYCOOKE MA, LMHC

Provider Business Mailing Address
First Line	:	PO BOX 536064
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32853-6064
Country	:	US
Telephone Number	:	407-403-1221
Fax Number	:

Provider Business Practice Location Address
First Line	:	8865 COMMODITY CIR
Second Line	:	UNIT 14, SUITE 106
City	:	ORLANDO
State	:	FL
Zip	:	32819-9077
Country	:	US
Telephone Number	:	407-403-1221
Fax Number	:

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

Provider Enumeration Date	:	11/29/2006
Last Update Date	:	10/24/2014

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