MEDICARE: SYLVIA ANN CLINGENPEEL L.P.C.

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	101YP2500X	Professional Counselor	4163	NC

General Provider Information

NPI Number	:	1346544459
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SYLVIA ANN CLINGENPEEL L.P.C.

Provider Business Mailing Address
First Line	:	365 OLD CHARLOTTE HWY
Second Line	:
City	:	FAIRVIEW
State	:	NC
Zip	:	28730-8790
Country	:	US
Telephone Number	:	828-231-3127
Fax Number	:

Provider Business Practice Location Address
First Line	:	3 WOODFIN AVE
Second Line	:
City	:	ASHEVILLE
State	:	NC
Zip	:	28804-3033
Country	:	US
Telephone Number	:	828-231-3127
Fax Number	:

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

Provider Enumeration Date	:	01/04/2011
Last Update Date	:	01/06/2011

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