Provider Demographics
NPI:1417362047
Name:NOVAK, JENNIFER (MS, LMFT, LPC)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:
Last Name:NOVAK
Suffix:
Gender:F
Credentials:MS, LMFT, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6907 DARTMOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20740-3705
Mailing Address - Country:US
Mailing Address - Phone:410-490-1071
Mailing Address - Fax:
Practice Address - Street 1:316 F ST NE STE 201
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-4934
Practice Address - Country:US
Practice Address - Phone:410-490-1071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-23
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC14426101Y00000X
DC000173106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor