Provider Demographics
NPI:1750455747
Name:JARRELL, JENNY LYNNE (LCSW C)
Entity Type:Individual
Prefix:MS
First Name:JENNY
Middle Name:LYNNE
Last Name:JARRELL
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 1:300 TALBOT STREET
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601
Mailing Address - Country:US
Mailing Address - Phone:410-822-1018
Mailing Address - Fax:410-820-5884
Practice Address - Street 1:208 CEDAR STREET
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21613
Practice Address - Country:US
Practice Address - Phone:410-476-4441
Practice Address - Fax:410-476-3087
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDKK811464Medicare ID - Type Unspecified