Provider Demographics
NPI:1235868225
Name:BALDWIN, JENNA (LCPC)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:BALDWIN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 SAINT CHARLES WAY UNIT E, BOX 372
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-4646
Mailing Address - Country:US
Mailing Address - Phone:443-367-1333
Mailing Address - Fax:
Practice Address - Street 1:815 RITCHIE HWY STE 205
Practice Address - Street 2:
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146-4164
Practice Address - Country:US
Practice Address - Phone:443-367-1333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-07
Last Update Date:2024-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC2929101YA0400X
MDLC15188101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health