MEDICARE: WINGER CLINICAL COUNSELING SERVICES, LLC

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1255942090
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WINGER CLINICAL COUNSELING SERVICES, LLC

Provider Business Mailing Address
First Line	:	5276 SAINT HELENA ST
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43221-5638
Country	:	US
Telephone Number	:	419-618-2660
Fax Number	:

Provider Business Practice Location Address
First Line	:	1016 S HIGH ST FL 2
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43206-2567
Country	:	US
Telephone Number	:	419-618-2660
Fax Number	:

Authorized Official
Title or Position	:	OWNER/SOCIAL WORKER
Name	:	COURTNEY WINGER
Credential	:	LISW-S
Telephone Number	:	419-618-2660

Provider Enumeration Date	:	08/14/2020
Last Update Date	:	08/14/2020

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