MEDICARE: HUMMINGBIRD CONSULTING, LLC.

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

General Provider Information

NPI Number	:	1750941787
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUMMINGBIRD CONSULTING, LLC.

Provider Business Mailing Address
First Line	:	215 HIGHLAND AVE STE C
Second Line	:
City	:	HADDON TWP
State	:	NJ
Zip	:	08108-2634
Country	:	US
Telephone Number	:	856-651-8869
Fax Number	:	856-581-4449

Provider Business Practice Location Address
First Line	:	215 HIGHLAND AVE STE C
Second Line	:
City	:	HADDON TWP
State	:	NJ
Zip	:	08108-2634
Country	:	US
Telephone Number	:	856-651-8869
Fax Number	:	856-581-4449

Authorized Official
Title or Position	:	ACCOUNT MANAGER
Name	:	MR. KEVIN D LIEBOLD
Credential	:
Telephone Number	:	609-686-9320

Provider Enumeration Date	:	06/20/2019
Last Update Date	:	06/26/2019

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