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General NPI Number Information
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NPI Number | 1407657612
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Entity Type | Individual
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Provider Name | JESSICA LAUREN COLLADO QUARANTO LCPC
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Gender | Female
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Dates
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Enumeration Date | 03/24/2025
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 3206 TOWER OAKS BLVD STE 300
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City | ROCKVILLE
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State | MD
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Zip | 20852-4220
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Country | US
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Telephone | 240-772-1199
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Fax |
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Provider Business Mailing Address
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Address Line | 8130 HARTFORD AVE
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City | SILVER SPRING
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State | MD
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Zip | 20910-4668
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Country | US
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Telephone | 202-302-8521
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LC10540
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License Number State | MD
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