Provider Demographics
NPI:1730652157
Name:METLEN, JENNIFER (LGPC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:METLEN
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23650 COVENTRY DR
Mailing Address - Street 2:
Mailing Address - City:LEONARDTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20650-5859
Mailing Address - Country:US
Mailing Address - Phone:484-653-7060
Mailing Address - Fax:
Practice Address - Street 1:41650 COURTHOUSE DR UNIT 301
Practice Address - Street 2:
Practice Address - City:LEONARDTOWN
Practice Address - State:MD
Practice Address - Zip Code:20650-3893
Practice Address - Country:US
Practice Address - Phone:301-690-0779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-08
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP9098101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor