Healthcare Provider Details

I. General information

NPI: 1528556586
Provider Name (Legal Business Name): JAZMONE SHERECE WILKERSON PH.D., LCPC, CMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JAZMONE SHERECE TAYLOR J.D., LCPC, NCE

II. Dates (important events)

Enumeration Date: 04/25/2018
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2735 CYLBURN AVE
BALTIMORE MD
21215-5319
US

IV. Provider business mailing address

2735 CYLBURN AVE
BALTIMORE MD
21215-5319
US

V. Phone/Fax

Practice location:
  • Phone: 202-200-5342
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLC9385
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: