MEDICARE: KARLEE P FENSTERMAKER 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	171M00000X	Case Manager/Care Coordinator		OH
2	101YP2500X	Professional Counselor	C.2204109	OH

General Provider Information

NPI Number	:	1295316495
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARLEE P FENSTERMAKER LPC

Provider Business Mailing Address
First Line	:	4102 GREENMONT DR SE
Second Line	:
City	:	WARREN
State	:	OH
Zip	:	44484-2614
Country	:	US
Telephone Number	:	330-718-1061
Fax Number	:

Provider Business Practice Location Address
First Line	:	4102 GREENMONT DR SE
Second Line	:
City	:	WARREN
State	:	OH
Zip	:	44484-2614
Country	:	US
Telephone Number	:	330-718-1061
Fax Number	:

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

Provider Enumeration Date	:	04/19/2021
Last Update Date	:	11/06/2024

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