MEDICARE: LYNNE RIFKIN SHINE LMHC CRC

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	101Y00000X	Counselor	1012680	NY

General Provider Information

NPI Number	:	1497456644
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNNE RIFKIN SHINE LMHC CRC

Provider Business Mailing Address
First Line	:	4800 N FRENCH RD
Second Line	:
City	:	EAST AMHERST
State	:	NY
Zip	:	14051-2178
Country	:	US
Telephone Number	:	716-689-3110
Fax Number	:

Provider Business Practice Location Address
First Line	:	4800 N FRENCH RD
Second Line	:
City	:	EAST AMHERST
State	:	NY
Zip	:	14051-2178
Country	:	US
Telephone Number	:	716-689-3110
Fax Number	:

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

Provider Enumeration Date	:	03/14/2023
Last Update Date	:	03/14/2023

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