Provider Demographics
NPI:1336838911
Name:JENNINGS, ERICKA SCHAIBLE (LGP15643)
Entity type:Individual
Prefix:
First Name:ERICKA
Middle Name:SCHAIBLE
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:LGP15643
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11812 KIGGER JACK LN
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20871-9320
Mailing Address - Country:US
Mailing Address - Phone:610-554-8703
Mailing Address - Fax:
Practice Address - Street 1:1395 PICCARD DR STE 110
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-4364
Practice Address - Country:US
Practice Address - Phone:301-769-5878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-01
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP15643101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health