Provider Demographics
NPI:1225302011
Name:MICHAEL, JEHARI (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:JEHARI
Middle Name:
Last Name:MICHAEL
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16490 CATHERINE WOODS CT
Mailing Address - Street 2:
Mailing Address - City:HUGHESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20637-3037
Mailing Address - Country:US
Mailing Address - Phone:301-613-4296
Mailing Address - Fax:
Practice Address - Street 1:16490 CATHERINE WOODS CT
Practice Address - Street 2:
Practice Address - City:HUGHESVILLE
Practice Address - State:MD
Practice Address - Zip Code:20637-3037
Practice Address - Country:US
Practice Address - Phone:301-613-4296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-27
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD17653104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker