MEDICARE: STEPHANIE LOEB BEILINSON 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	101YM0800X	Mental Health Counselor
2	101YP2500X	Professional Counselor	002543	CT

General Provider Information

NPI Number	:	1720348519
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE LOEB BEILINSON LPC

Provider Business Mailing Address
First Line	:	17 ANN ST
Second Line	:
City	:	TRUMBULL
State	:	CT
Zip	:	06611-1955
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	743 SOUTH AVE
Second Line	:
City	:	BRIDGEPORT
State	:	CT
Zip	:	06604-5810
Country	:	US
Telephone Number	:	203-332-3154
Fax Number	:

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

Provider Enumeration Date	:	05/25/2012
Last Update Date	:	03/17/2018

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