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NPI Code Detail

MEDICARE: DR. JACLYN HALPERN

MEDICARE: DR. JACLYN HALPERN
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
1103T00000XPsychologist04748MD

General Provider Information

NPI Number : 1245628460
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JACLYN HALPERN
Provider Business Mailing Address
First Line : 5480 WISCONSIN AVE STE 223
Second Line :
City : CHEVY CHASE
State : MD
Zip : 20815-3503
Country : US
Telephone Number : 301-576-6044
Fax Number :
Provider Business Practice Location Address
First Line : 5480 WISCONSIN AVE STE 223
Second Line :
City : CHEVY CHASE
State : MD
Zip : 20815-3503
Country : US
Telephone Number : 301-576-6044
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/23/2014
Last Update Date : 08/02/2022

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