MEDICARE: COURTNEY TOMASZEWSKI LMHC, 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	178.013339	IL
2	101YP2500X	Professional Counselor	180.013078	IL
3	101YP2500X	Professional Counselor	39003833A	IN

General Provider Information

NPI Number	:	1427562198
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COURTNEY TOMASZEWSKI LMHC, LCPC

Provider Business Mailing Address
First Line	:	1265 S LAKE PARK AVE
Second Line	:
City	:	HOBART
State	:	IN
Zip	:	46342-5961
Country	:	US
Telephone Number	:	219-323-3311
Fax Number	:

Provider Business Practice Location Address
First Line	:	1265 S LAKE PARK AVE
Second Line	:
City	:	HOBART
State	:	IN
Zip	:	46342-5961
Country	:	US
Telephone Number	:	219-323-3311
Fax Number	:

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

Provider Enumeration Date	:	11/16/2017
Last Update Date	:	11/12/2021

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