MEDICARE: MS. JANINE HELEN JOLY-DEMARS LCMFT

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	106H00000X	Marriage & Family Therapist	LCM717	MD

General Provider Information

NPI Number	:	1790321396
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JANINE HELEN JOLY-DEMARS LCMFT

Provider Business Mailing Address
First Line	:	4905 DEL RAY AVE STE 301
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20814-2558
Country	:	US
Telephone Number	:	240-752-7650
Fax Number	:

Provider Business Practice Location Address
First Line	:	4905 DEL RAY AVE STE 301
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20814-2558
Country	:	US
Telephone Number	:	240-505-7477
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/19/2019
Last Update Date	:	11/20/2019

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