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General NPI Number Information
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NPI Number | 1275955593
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Entity Type | Individual
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Provider Name | JEROME D GARRETT SR. LCPC, NCC
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Gender | Male
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Dates
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Enumeration Date | 01/07/2014
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Last Update Date | 06/29/2016
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Provider Practice Location Address
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Address Line | 402 PATRIOTS WAY
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City | ELKTON
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State | MD
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Zip | 21921-5101
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Country | US
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Telephone | 302-312-7141
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Fax |
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Provider Business Mailing Address
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Address Line | 402 PATRIOTS WAY
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City | ELKTON
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State | MD
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Zip | 21921-5101
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Country | US
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Telephone | 302-312-7141
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LC7117
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License Number State | MD
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