Provider Demographics
NPI:1609960145
Name:FRENCH, JODI LENOIR (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JODI
Middle Name:LENOIR
Last Name:FRENCH
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 RIVERSIDE DRIVE
Mailing Address - Street 2:
Mailing Address - City:NORTH EAST
Mailing Address - State:MD
Mailing Address - Zip Code:21901
Mailing Address - Country:US
Mailing Address - Phone:443-956-7945
Mailing Address - Fax:410-658-0088
Practice Address - Street 1:CHESAPEAKE BEHAVIORAL HEALTH
Practice Address - Street 2:221-C EAST MAIN STREET
Practice Address - City:RISING SUN
Practice Address - State:MD
Practice Address - Zip Code:21911
Practice Address - Country:US
Practice Address - Phone:443-956-7945
Practice Address - Fax:410-658-0088
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02812103G00000X, 103TC0700X, 103TC2200X, 103T00000X, 103TS0200X
VA0810001953103G00000X, 103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD527202-03OtherBLUE CROSS BLUE SHIELD
MDKS40Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER