Provider Demographics
NPI:1649467408
Name:SHERWIN, JENNIFER BROOKE (LCPC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:BROOKE
Last Name:SHERWIN
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 1:15 WORMANS MILL CT
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-3019
Mailing Address - Country:US
Mailing Address - Phone:321-243-2760
Mailing Address - Fax:
Practice Address - Street 1:15 WORMANS MILL CT
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-3019
Practice Address - Country:US
Practice Address - Phone:321-243-2760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-26
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC2566101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDLC2566Medicaid