Provider Demographics
NPI:1780703835
Name:LOMBARDI, JESSICA L (LCPC)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:L
Last Name:LOMBARDI
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 1:4801 DORSEY HALL DR
Mailing Address - Street 2:SUITE 212
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-7766
Mailing Address - Country:US
Mailing Address - Phone:410-715-0200
Mailing Address - Fax:410-715-4696
Practice Address - Street 1:4801 DORSEY HALL DR
Practice Address - Street 2:SUITE 212
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-7766
Practice Address - Country:US
Practice Address - Phone:410-715-0200
Practice Address - Fax:410-715-4696
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC1908101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health