Healthcare Provider Details

I. General information

NPI: 1003921248
Provider Name (Legal Business Name): JADRANKA MILOVANOVIC LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 09/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 N ROLLING RD
CATONSVILLE MD
21228-4134
US

IV. Provider business mailing address

10632 LITTLE PATUXENT PKWY STE 343
COLUMBIA MD
21044-6239
US

V. Phone/Fax

Practice location:
  • Phone: 410-788-0300
  • Fax:
Mailing address:
  • Phone: 443-955-4592
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License NumberLC1778
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: