Provider Demographics
NPI:1134687205
Name:SANTUCCI-FREEMAN, JENNA R (LCSW-C)
Entity Type:Individual
Prefix:MRS
First Name:JENNA
Middle Name:R
Last Name:SANTUCCI-FREEMAN
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9841 WASHINGTON BLVD
Mailing Address - Street 2:SUITE 200 #1127
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-8655
Mailing Address - Country:US
Mailing Address - Phone:240-356-8007
Mailing Address - Fax:
Practice Address - Street 1:9841 WASHINGTON BLVD
Practice Address - Street 2:SUITE 200 #1127
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-8655
Practice Address - Country:US
Practice Address - Phone:240-356-8007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-07
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD194921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical