Provider Demographics
NPI:1972545234
Name:MOLINARI, JENNIFER S (LCPC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:S
Last Name:MOLINARI
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10715 CHARTER DR
Mailing Address - Street 2:STE.270
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-2882
Mailing Address - Country:US
Mailing Address - Phone:410-707-5786
Mailing Address - Fax:410-992-7073
Practice Address - Street 1:10630 LITTLE PATUXENT PKWY
Practice Address - Street 2:SUITE 209
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3264
Practice Address - Country:US
Practice Address - Phone:410-740-8066
Practice Address - Fax:410-740-8068
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2014-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC1988101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCM3280008OtherBC/BS NATL CAP REGION
MD64635203OtherCAREFIRST RENDERING