MEDICARE: MRS. MARLEE JANE BARDENETT LCPC, LPC

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	101YM0800X	Mental Health Counselor	LC10183	MD
2	101YM0800X	Mental Health Counselor	0701008409	VA

General Provider Information

NPI Number	:	1871149658
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARLEE JANE BARDENETT LCPC, LPC

Provider Business Mailing Address
First Line	:	124 N COURT ST
Second Line	:
City	:	FREDERICK
State	:	MD
Zip	:	21701-6614
Country	:	US
Telephone Number	:	301-304-7108
Fax Number	:

Provider Business Practice Location Address
First Line	:	3534 URBANA PIKE STE C
Second Line	:
City	:	FREDERICK
State	:	MD
Zip	:	21704-7786
Country	:	US
Telephone Number	:	301-304-7108
Fax Number	:

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

Provider Enumeration Date	:	08/16/2019
Last Update Date	:	06/09/2025

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