MEDICARE: DR. YELENA GIDENKO PHD, LPC, DCC

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	7228	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891930160
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YELENA GIDENKO PHD, LPC, DCC

Provider Business Mailing Address
First Line	:	140 PRESTON EXECUTIVE DR STE 100E
Second Line	:
City	:	CARY
State	:	NC
Zip	:	27513-8488
Country	:	US
Telephone Number	:	919-428-3196
Fax Number	:	866-416-5628

Provider Business Practice Location Address
First Line	:	140 PRESTON EXECUTIVE DR STE 100E
Second Line	:
City	:	CARY
State	:	NC
Zip	:	27513-8488
Country	:	US
Telephone Number	:	919-428-3196
Fax Number	:	866-416-5628

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

Provider Enumeration Date	:	12/15/2008
Last Update Date	:	12/20/2017

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