Provider Demographics
NPI:1467129023
Name:DEINLEIN, JEREMY PATRICK (LCSW-C)
Entity type:Individual
Prefix:
First Name:JEREMY
Middle Name:PATRICK
Last Name:DEINLEIN
Suffix:
Gender:M
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 BALTIMORE ST STE 5
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-3072
Mailing Address - Country:US
Mailing Address - Phone:301-531-4690
Mailing Address - Fax:
Practice Address - Street 1:31 BALTIMORE ST STE 5
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-3072
Practice Address - Country:US
Practice Address - Phone:301-531-4690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-23
Last Update Date:2025-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD276461041C0700X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker