Provider Demographics
NPI:1265151500
Name:MOHLER, JEREMY (LCPC)
Entity type:Individual
Prefix:
First Name:JEREMY
Middle Name:
Last Name:MOHLER
Suffix:
Gender:
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3450 ELM AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21211-2417
Mailing Address - Country:US
Mailing Address - Phone:301-752-8413
Mailing Address - Fax:
Practice Address - Street 1:3450 ELM AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21211-2417
Practice Address - Country:US
Practice Address - Phone:301-752-8413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-22
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health