MEDICARE: NATASHA PIECZYNSKI I LMFT

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	106H00000X	Marriage & Family Therapist	KY 115	KY

General Provider Information

NPI Number	:	1639386154
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATASHA PIECZYNSKI I LMFT

Provider Business Mailing Address
First Line	:	1951 BISHOP LN STE 204
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40218-1923
Country	:	US
Telephone Number	:	502-479-4433
Fax Number	:	502-451-5949

Provider Business Practice Location Address
First Line	:	1951 BISHOP LN STE 204
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40218-1923
Country	:	US
Telephone Number	:	502-479-4433
Fax Number	:	502-451-5949

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

Provider Enumeration Date	:	05/16/2007
Last Update Date	:	09/23/2008

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