Provider Demographics
NPI:1790321396
Name:JOLY-DEMARS, JANINE HELEN (LCMFT)
Entity Type:Individual
Prefix:MS
First Name:JANINE
Middle Name:HELEN
Last Name:JOLY-DEMARS
Suffix:
Gender:F
Credentials:LCMFT
Other - Prefix:
Other - First Name:JANINE
Other - Middle Name:HELEN
Other - Last Name:JOLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4905 DEL RAY AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-2558
Mailing Address - Country:US
Mailing Address - Phone:240-752-7650
Mailing Address - Fax:
Practice Address - Street 1:4905 DEL RAY AVE STE 301
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-2558
Practice Address - Country:US
Practice Address - Phone:240-505-7477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-19
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCM717106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist