Park, Jennifer Alane
Park, Jennifer Alane is an individual health care provider with primary practice located at 200 Wood Hill Rd , Rockville MD 20850-8724. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Park, Jennifer Alane can be contacted via phone (301) 838-4200.Contact Information
Primary practice address
200 Wood Hill Rd
Rockville MD 20850-8724
Phone: (301) 838-4200
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | LC50079244 | District of Columbia |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 17943 | Maryland |
Profile Details
| NPI number | 1427392760 |
|---|---|
| LBN Legal business name | Park, Jennifer Alane |
| Credentials | LCSW-C, LICSW |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 26th, 2012 |
| Last updated | Dec 2nd, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1427392760 | NPPES |
| Maryland | Other | 12455520 | CAQH |
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