Provider Demographics
NPI:1255426573
Name:NOWELL, J'AIME
Entity type:Individual
Prefix:
First Name:J'AIME
Middle Name:
Last Name:NOWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 MARYLAND AVE
Mailing Address - Street 2:#10
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-1654
Mailing Address - Country:US
Mailing Address - Phone:410-279-1400
Mailing Address - Fax:
Practice Address - Street 1:1160 SPA RD
Practice Address - Street 2:SUITE 1B
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21403-1022
Practice Address - Country:US
Practice Address - Phone:410-279-1400
Practice Address - Fax:410-280-5464
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCA285101YA0400X
MD109461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD246728OtherCOMPSYCH
MD644565-01OtherBC/BS