Provider Demographics
NPI:1699486332
Name:FURBUSH, JAMIA MICHELLE (MSW, LCSW-C)
Entity type:Individual
Prefix:
First Name:JAMIA
Middle Name:MICHELLE
Last Name:FURBUSH
Suffix:
Gender:F
Credentials:MSW, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7523 GRINDSTONE CT
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE BEACH
Mailing Address - State:MD
Mailing Address - Zip Code:20732-4121
Mailing Address - Country:US
Mailing Address - Phone:301-509-1530
Mailing Address - Fax:
Practice Address - Street 1:7523 GRINDSTONE CT
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE BEACH
Practice Address - State:MD
Practice Address - Zip Code:20732-4121
Practice Address - Country:US
Practice Address - Phone:301-509-1530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-13
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD19866104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty