Provider Demographics
NPI:1417251182
Name:VINIK, JESSIE LEVIN (MS, LCPC)
Entity Type:Individual
Prefix:
First Name:JESSIE
Middle Name:LEVIN
Last Name:VINIK
Suffix:
Gender:F
Credentials:MS, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6917 ARLINGTON RD
Mailing Address - Street 2:SUITE 222
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-5211
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6917 ARLINGTON RD
Practice Address - Street 2:SUITE 222
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-5211
Practice Address - Country:US
Practice Address - Phone:301-233-8091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-10
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC4769101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health