MEDICARE: CHRISTINE DIEBEL HEMPSTED LMHC

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	101YS0200X	School Counselor	MH3962	FL
2	101YM0800X	Mental Health Counselor	MH3962	FL

General Provider Information

NPI Number	:	1790357804
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE DIEBEL HEMPSTED LMHC

Provider Business Mailing Address
First Line	:	2009 OAKHURST AVE
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32792-2578
Country	:	US
Telephone Number	:	321-228-8273
Fax Number	:

Provider Business Practice Location Address
First Line	:	2009 OAKHURST AVE
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32792-2578
Country	:	US
Telephone Number	:	321-228-8273
Fax Number	:

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

Provider Enumeration Date	:	07/16/2021
Last Update Date	:	07/16/2021

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