Provider Demographics
NPI:1528295904
Name:MCWHORTER, JESSICA HEATHER (PHD)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:HEATHER
Last Name:MCWHORTER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:JESSICA
Other - Middle Name:HEATHER
Other - Last Name:MCWHORTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5051 GREENSPRING AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-4354
Mailing Address - Country:US
Mailing Address - Phone:410-601-7375
Mailing Address - Fax:
Practice Address - Street 1:5051 GREENSPRING AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-4354
Practice Address - Country:US
Practice Address - Phone:410-601-7375
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-12
Last Update Date:2012-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04913103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical