Provider Demographics
NPI:1902636947
Name:PRICE, JERI
Entity type:Individual
Prefix:
First Name:JERI
Middle Name:
Last Name:PRICE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JERI
Other - Middle Name:LYNN
Other - Last Name:PRICE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LGPC
Mailing Address - Street 1:8307 TELEGRAPH RD APT 386
Mailing Address - Street 2:
Mailing Address - City:ODENTON
Mailing Address - State:MD
Mailing Address - Zip Code:21113-1377
Mailing Address - Country:US
Mailing Address - Phone:301-957-1391
Mailing Address - Fax:
Practice Address - Street 1:4404 QUEENSNSBURY ROAD
Practice Address - Street 2:UNIT 210
Practice Address - City:RIVERDALE
Practice Address - State:MD
Practice Address - Zip Code:20737
Practice Address - Country:US
Practice Address - Phone:301-851-5828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-05
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGPC167000101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health