MEDICARE: MARIA CHYBICKI 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	101YM0800X	Mental Health Counselor	MH19350	FL
2	101YP2500X	Professional Counselor	180.003928	IL

General Provider Information

NPI Number	:	1215207816
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA CHYBICKI LCPC

Provider Business Mailing Address
First Line	:	19654 VILLA ROSA LOOP
Second Line	:
City	:	ESTERO
State	:	FL
Zip	:	33967-5713
Country	:	US
Telephone Number	:	708-207-8713
Fax Number	:

Provider Business Practice Location Address
First Line	:	19654 VILLA ROSA LOOP
Second Line	:
City	:	ESTERO
State	:	FL
Zip	:	33967-5713
Country	:	US
Telephone Number	:	708-207-8713
Fax Number	:

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

Provider Enumeration Date	:	01/12/2012
Last Update Date	:	10/27/2023

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