Provider Demographics
NPI:1649718529
Name:CARLEY, JENNIFER (NCC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:CARLEY
Suffix:
Gender:
Credentials:NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3522 SILVERSIDE RD
Mailing Address - Street 2:SUITE 32
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-4916
Mailing Address - Country:US
Mailing Address - Phone:410-920-3304
Mailing Address - Fax:
Practice Address - Street 1:3522 SILVERSIDE RD
Practice Address - Street 2:SUITE 32
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-4916
Practice Address - Country:US
Practice Address - Phone:410-920-3304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-10
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC12841101YP2500X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional