Provider Demographics
NPI:1457839037
Name:BISCOE, JACLYN (LCPC)
Entity Type:Individual
Prefix:
First Name:JACLYN
Middle Name:
Last Name:BISCOE
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 1:20815 INDIAN BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CALIFORNIA
Mailing Address - State:MD
Mailing Address - Zip Code:20619-2310
Mailing Address - Country:US
Mailing Address - Phone:301-690-5509
Mailing Address - Fax:
Practice Address - Street 1:21945 THREE NOTCH RD STE 102
Practice Address - Street 2:
Practice Address - City:LEXINGTON PARK
Practice Address - State:MD
Practice Address - Zip Code:20653-1563
Practice Address - Country:US
Practice Address - Phone:301-690-5509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-05
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC11435101YP2500X
MDLGP8671101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional