Healthcare Provider Details

I. General information

NPI: 1780203331
Provider Name (Legal Business Name): JESSICA ROCHELLE FLOWERS LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2020
Last Update Date: 07/03/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 ALTO VISTA AVE
BALTIMORE MD
21207-5240
US

IV. Provider business mailing address

61800 ALTO VISTA AVE
BALTIMORE MD
21207-5240
US

V. Phone/Fax

Practice location:
  • Phone: 443-804-4460
  • Fax:
Mailing address:
  • Phone: 443-804-4460
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number23014
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number23014
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: