MEDICARE: LAURA LYNNE WINTERS LCSW

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	1041C0700X	Clinical Social Worker	44SC05249500	NJ

General Provider Information

NPI Number	:	1952436735
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA LYNNE WINTERS LCSW

Provider Business Mailing Address
First Line	:	30 RIDGE PL
Second Line	:
City	:	WAYNE
State	:	NJ
Zip	:	07470-5162
Country	:	US
Telephone Number	:	732-757-6774
Fax Number	:

Provider Business Practice Location Address
First Line	:	368 MAIN ST
Second Line	:
City	:	CHATHAM
State	:	NJ
Zip	:	07928-2112
Country	:	US
Telephone Number	:	862-200-7218
Fax Number	:

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

Provider Enumeration Date	:	02/22/2007
Last Update Date	:	06/10/2020

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