Provider Demographics
NPI:1124824107
Name:NEUMAN, JEANIE TIEU (LGPC)
Entity type:Individual
Prefix:
First Name:JEANIE
Middle Name:TIEU
Last Name:NEUMAN
Suffix:
Gender:
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 WAGON WHEEL CT
Mailing Address - Street 2:
Mailing Address - City:GLEN ARM
Mailing Address - State:MD
Mailing Address - Zip Code:21057-9431
Mailing Address - Country:US
Mailing Address - Phone:443-762-8173
Mailing Address - Fax:
Practice Address - Street 1:724 DULANEY VALLEY RD STE 2
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-5111
Practice Address - Country:US
Practice Address - Phone:443-762-8173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-20
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP15580101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health