Healthcare Provider Details

I. General information

NPI: 1306406996
Provider Name (Legal Business Name): JAIMEY MCCLURKIN LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2019
Last Update Date: 09/06/2026
Certification Date: 09/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 BETHESDA METRO CTR STE 700
BETHESDA MD
20814-6300
US

IV. Provider business mailing address

PO BOX 281
ODENTON MD
21113-0281
US

V. Phone/Fax

Practice location:
  • Phone: 646-760-2248
  • Fax:
Mailing address:
  • Phone: 410-350-4381
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLC9580
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: