MEDICARE: JENNIFER NOEL CARY L.C.P.C.

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
1	101YM0800X	Mental Health Counselor	LC-1955	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0701006080	OTHER	VA	COMMONWEALTH OF VA BOARD OF COUNSELING
2	LC-1955	OTHER	MD	BOARD OF PROFESSIONAL COUNSELORS AND THERAPISTS
3	PRC14625	OTHER	DC	DOH, HEALTH REGULATION AND LICENSING ADMIN, BOARD OF PROFESSIONAL COUNSELING

General Provider Information

NPI Number	:	1871633644
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER NOEL CARY L.C.P.C.

Provider Business Mailing Address
First Line	:	3566 LOWLEN CT
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21042-3855
Country	:	US
Telephone Number	:	443-413-3928
Fax Number	:

Provider Business Practice Location Address
First Line	:	9841 BROKEN LAND PKWY STE 211
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21046-3068
Country	:	US
Telephone Number	:	443-708-5856
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/08/2007
Last Update Date	:	01/18/2022

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