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Organization
JESSE FAIRCHILD LLC
Active
Organization
JESSE FAIRCHILD LLC
Active
Other names
Bodhi Counseling, Bodhi
Organization subpart
No
Provider details
NPI number
Authorized official
JANICE LESLIE FAIRCHILD CHAVERO (PRACTICE OWNER)
(443) 877-4044
Entity
Organization
Contact information
Practice address
2057 PULASKI HWY STE 4, NORTH EAST, MD 21901-3744
(443) 877-4044
(443) 967-0077
Mailing address
2057 PULASKI HWY STE 4, NORTH EAST, MD 21901-3744
(443) 877-4044
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LC2857
MD
1041C0700X
Clinical Social Worker
—
NULL
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
NULL
106H00000X
Marriage & Family Therapist
—
—
221700000X
Art Therapist
—
NULL
221700000X
Art Therapist
—
—
Other
Enumeration date
01/29/2012
Last updated
01/10/2026
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