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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
106H00000X
Marriage & Family Therapist
221700000X
Art Therapist

Other

Enumeration date
01/29/2012
Last updated
01/10/2026
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