MEDICARE: MRS. JENNIFER B WEINER M.ED., 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	101YP2500X	Professional Counselor	001116	PA

General Provider Information

NPI Number	:	1619317013
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JENNIFER B WEINER M.ED., LPC

Provider Business Mailing Address
First Line	:	6004 OLD EAGLE RD
Second Line	:
City	:	FORT WASHINGTON
State	:	PA
Zip	:	19034-1811
Country	:	US
Telephone Number	:	610-941-2646
Fax Number	:

Provider Business Practice Location Address
First Line	:	6004 OLD EAGLE RD
Second Line	:
City	:	FORT WASHINGTON
State	:	PA
Zip	:	19034-1811
Country	:	US
Telephone Number	:	610-941-2646
Fax Number	:

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

Provider Enumeration Date	:	06/28/2013
Last Update Date	:	06/28/2013

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