Provider Demographics
NPI:1316323520
Name:SCHLADT, JESSICA ELLIN (LPC, NCC)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:ELLIN
Last Name:SCHLADT
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:ELLIN
Other - Last Name:BLACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9368 PENROSE ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21704-7339
Mailing Address - Country:US
Mailing Address - Phone:757-204-1472
Mailing Address - Fax:
Practice Address - Street 1:9368 PENROSE ST
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21704-7339
Practice Address - Country:US
Practice Address - Phone:757-204-1472
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-11
Last Update Date:2025-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA8524101YM0800X
TX80611101YM0800X
MDLC12257101YM0800X
RIMHC00927101YM0800X
VA0701006034101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health