Healthcare Provider Details

I. General information

NPI: 1073737698
Provider Name (Legal Business Name): JENNIFER THORPE PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 BALTIMORE ANNAPOLIS BLVD SUITE 200
SEVERNA PARK MD
21146-3915
US

IV. Provider business mailing address

127 ROUND BAY RD
SEVERNA PARK MD
21146-4648
US

V. Phone/Fax

Practice location:
  • Phone: 443-440-2897
  • Fax:
Mailing address:
  • Phone: 443-440-2897
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number04803
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number2994
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: