MEDICARE: MISS JEANINE D'ONOFRIO LMHC, NCC

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	MH7463	FL

General Provider Information

NPI Number	:	1962447433
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS JEANINE D'ONOFRIO LMHC, NCC

Provider Business Mailing Address
First Line	:	539 E ROSEWOOD LN
Second Line	:
City	:	TAVARES
State	:	FL
Zip	:	32778-4821
Country	:	US
Telephone Number	:	352-408-7723
Fax Number	:	352-742-8305

Provider Business Practice Location Address
First Line	:	1799 SALK AVE
Second Line	:
City	:	TAVARES
State	:	FL
Zip	:	32778-4311
Country	:	US
Telephone Number	:	352-742-8300
Fax Number	:	352-742-8305

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

Provider Enumeration Date	:	06/18/2006
Last Update Date	:	07/08/2007

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