Provider Demographics
NPI:1396480042
Name:GEE, JENNIFER KELLY (LGPC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:KELLY
Last Name:GEE
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:KELLY
Other - Last Name:GEE-PETERSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LGPC
Mailing Address - Street 1:6229 LINGANORE RD
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-4727
Mailing Address - Country:US
Mailing Address - Phone:301-639-7180
Mailing Address - Fax:
Practice Address - Street 1:6229 LINGANORE RD
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-4727
Practice Address - Country:US
Practice Address - Phone:301-639-7180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-27
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP12559101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty