Provider Demographics
NPI:1003531195
Name:NIEHAUS, JOLENE (LCPC)
Entity Type:Individual
Prefix:
First Name:JOLENE
Middle Name:
Last Name:NIEHAUS
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:JOLENE
Other - Middle Name:
Other - Last Name:FLORIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1229
Mailing Address - Street 2:
Mailing Address - City:SYKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21784-1229
Mailing Address - Country:US
Mailing Address - Phone:410-552-0773
Mailing Address - Fax:443-200-0267
Practice Address - Street 1:535 OLD WESTMINSTER PIKE STE 106
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-6267
Practice Address - Country:US
Practice Address - Phone:410-552-0773
Practice Address - Fax:443-200-0267
Is Sole Proprietor?:No
Enumeration Date:2022-10-11
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC12812101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional