Healthcare Provider Details

I. General information

NPI: 1780759076
Provider Name (Legal Business Name): JEAN FRENKIL AYERS PSY D, PA-C, LCM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JEAN E FRENKIL PSY D; PA-C, LCM

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 09/12/2026
Certification Date: 09/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 S CROSS ST FL 2
CHESTERTOWN MD
21620-1549
US

IV. Provider business mailing address

112 S CROSS ST FL 2
CHESTERTOWN MD
21620-1549
US

V. Phone/Fax

Practice location:
  • Phone: 443-282-0481
  • Fax:
Mailing address:
  • Phone: 443-282-0481
  • Fax: 443-755-7507

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberMA054657
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberOA002811
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberLCM00003
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number02442
License Number StateMD
# 5
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number02442
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: