Provider Demographics
NPI:1811489750
Name:CALTON, JENNA M (PHD)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:M
Last Name:CALTON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7300 CALHOUN PL STE 700
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20855-3702
Mailing Address - Country:US
Mailing Address - Phone:240-777-4389
Mailing Address - Fax:240-777-4470
Practice Address - Street 1:7300 CALHOUN PL STE 700
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20855-3702
Practice Address - Country:US
Practice Address - Phone:240-777-4389
Practice Address - Fax:240-777-4470
Is Sole Proprietor?:No
Enumeration Date:2018-06-06
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06030103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical