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NPI Code Detail

MEDICARE: MR. JOSE HERNANDEZ LGPC

MEDICARE:  MR. JOSE  HERNANDEZ  LGPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorLC11563MD

General Provider Information

NPI Number : 1407415847
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOSE HERNANDEZ LGPC
Provider Business Mailing Address
First Line : 12200 TECH RD STE 330
Second Line :
City : SILVER SPRING
State : MD
Zip : 20904-1913
Country : US
Telephone Number : 301-572-6585
Fax Number : 301-572-7913
Provider Business Practice Location Address
First Line : 12200 TECH RD STE 330
Second Line :
City : SILVER SPRING
State : MD
Zip : 20904-1913
Country : US
Telephone Number : 301-572-6585
Fax Number : 301-572-7913
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2019
Last Update Date : 07/11/2024

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Directions to “ MR. JOSE HERNANDEZ LGPC” Practice Location

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