| Shawntay Fenyo, Llc | |
|
1811 Saunders Way Glen Burnie MD 21061-4331 | |
| (443) 962-2479 | |
| Not Available |
| Full Name | Shawntay Fenyo, Llc |
|---|---|
| Speciality | Counselor |
| Location | 1811 Saunders Way, Glen Burnie, Maryland |
| Authorized Official Name and Position | Shawntay Fenyo (PRESIDENT/OWNER) |
| Authorized Official Contact | 4439622479 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shawntay Fenyo, Llc 1811 Saunders Way Glen Burnie MD 21061-4331 Ph: (443) 962-2479 | Shawntay Fenyo, Llc 1811 Saunders Way Glen Burnie MD 21061-4331 Ph: (443) 962-2479 |
| NPI Number | 1770101461 |
|---|---|
| Provider Enumeration Date | 07/08/2020 |
| Last Update Date | 01/29/2025 |
| Certification Date | 01/29/2025 |
| Medicare PECOS PAC ID | 5597102079 |
|---|---|
| Medicare Enrollment ID | O20240319003972 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770101461 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Shawntay Theresa Fenyo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1821562190 PECOS PAC ID: 6406293984 Enrollment ID: I20240319004038 |
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