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General NPI Number Information
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NPI Number | 1881098663
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Entity Type | Individual
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Provider Name | JESSICA N GOMEL LCPC
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Gender | Female
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Dates
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Enumeration Date | 10/22/2014
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Last Update Date | 01/16/2023
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Provider Practice Location Address
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Address Line | 260 GATEWAY DR STE 3-4C
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City | BEL AIR
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State | MD
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Zip | 21014-4268
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Country | US
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Telephone | 443-595-6585
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Fax |
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Provider Business Mailing Address
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Address Line | 5 DEER OAK CT
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City | PHOENIX
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State | MD
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Zip | 21131-1853
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Country | US
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Telephone | 443-595-6585
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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 | LC7445
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License Number State | MD
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