Provider Demographics
NPI:1528070836
Name:UDLER, JENNIFER ANNE (LCSW-C)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:ANNE
Last Name:UDLER
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:WOLPERT
Other - Last Name:UDLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:200 WOOD HILL RD
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-8724
Mailing Address - Country:US
Mailing Address - Phone:301-838-4200
Mailing Address - Fax:301-309-2596
Practice Address - Street 1:200 WOOD HILL RD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-8724
Practice Address - Country:US
Practice Address - Phone:301-838-4200
Practice Address - Fax:301-309-2596
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD11026104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD233484OtherKAISER
MD900802100Medicaid
DCA2840094OtherBCBS OF DC
MD279797000OtherMAGELLAN
MD7925287OtherAETNA
DCA2840094OtherBCBS OF DC