Organization
JENNIFER WILSON LCSWC LCADC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JENNIFER W WILSON LCSWC, LCADC (OWNER)
(410) 868-0001
Entity
Organization
Contact information
Practice address
9199 REISTERSTOWN RD STE 202B, OWINGS MILLS, MD 21117-4579
(410) 868-0001
Mailing address
16528 FALLS RD, UPPERCO, MD 21155-9483
(410) 868-0001
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCA2105
MD
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
18028
MD
Other
Enumeration date
09/03/2018
Last updated
03/03/2023
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