Individual
MRS. JACKLYN AMANKWA-AMOYAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW-C
Contact information
Practice address
5902 BROOKE JANE DR, CLINTON, MD 20735-4114
(240) 421-4312
Mailing address
5902 BROOKE JANE DR, CLINTON, MD 20735-4114
(240) 421-4312
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
20993
MD
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
267002000
—
MD
Enumeration date
07/27/2018
Last updated
05/22/2025
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