MEDICARE: JCR MENTAL HEALTH SERVICES LLC

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1194510800
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JCR MENTAL HEALTH SERVICES LLC

Provider Business Mailing Address
First Line	:	12501 TIMBER GROVE RD
Second Line	:
City	:	REISTERSTOWN
State	:	MD
Zip	:	21136-1819
Country	:	US
Telephone Number	:	443-421-5081
Fax Number	:	443-329-8260

Provider Business Practice Location Address
First Line	:	4727 OLD COURT RD
Second Line	:
City	:	PIKESVILLE
State	:	MD
Zip	:	21208-2347
Country	:	US
Telephone Number	:	443-826-9066
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CECILIA PARKER
Credential	:	PMHNP-BC
Telephone Number	:	443-421-5081

Provider Enumeration Date	:	04/12/2025
Last Update Date	:	04/12/2025

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