1972545234 NPI number — JENNIFER S MOLINARI LCPC

Table of content: JENNIFER S MOLINARI LCPC (NPI 1972545234)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972545234 NPI number — JENNIFER S MOLINARI LCPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MOLINARI
Provider First Name:
JENNIFER
Provider Middle Name:
S
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1972545234
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/17/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10715 CHARTER DR
Provider Second Line Business Mailing Address:
STE.270
Provider Business Mailing Address City Name:
COLUMBIA
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21044-2882
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-707-5786
Provider Business Mailing Address Fax Number:
410-992-7073

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10630 LITTLE PATUXENT PKWY
Provider Second Line Business Practice Location Address:
SUITE 209
Provider Business Practice Location Address City Name:
COLUMBIA
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21044-3264
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-740-8066
Provider Business Practice Location Address Fax Number:
410-740-8068
Provider Enumeration Date:
06/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  LC1988 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: M3280008 . This is a "BC/BS NATL CAP REGION" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 64635203 . This is a "CAREFIRST RENDERING" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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