MEDICARE: KRISTIN JANEE' WINBUSH LPC-MHSP

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	4156	TN

General Provider Information

NPI Number	:	1336300656
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTIN JANEE' WINBUSH LPC-MHSP

Provider Business Mailing Address
First Line	:	5909 SHELBY OAKS DR STE 117
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38134-7318
Country	:	US
Telephone Number	:	901-361-2330
Fax Number	:

Provider Business Practice Location Address
First Line	:	5909 SHELBY OAKS DR STE 117
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38134-7318
Country	:	US
Telephone Number	:	901-361-2330
Fax Number	:

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

Provider Enumeration Date	:	06/19/2008
Last Update Date	:	01/28/2019

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