Provider Demographics
NPI:1720610843
Name:HEWES, JEREMY CHARLES (LCPC)
Entity Type:Individual
Prefix:
First Name:JEREMY
Middle Name:CHARLES
Last Name:HEWES
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5112 OLD SWIMMING POOL RD
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21703-5866
Mailing Address - Country:US
Mailing Address - Phone:240-315-8272
Mailing Address - Fax:
Practice Address - Street 1:5229 NEW DESIGN RD
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21703-7103
Practice Address - Country:US
Practice Address - Phone:301-668-1320
Practice Address - Fax:301-696-1390
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-06
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty