Provider Demographics
NPI:1871149658
Name:BARDENETT, MARLEE JANE (LCPC, LPC)
Entity type:Individual
Prefix:MRS
First Name:MARLEE
Middle Name:JANE
Last Name:BARDENETT
Suffix:
Gender:F
Credentials:LCPC, LPC
Other - Prefix:MS
Other - First Name:MARLEE
Other - Middle Name:JANE
Other - Last Name:BURROUGHS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:124 N COURT ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-6614
Mailing Address - Country:US
Mailing Address - Phone:301-304-7108
Mailing Address - Fax:
Practice Address - Street 1:124 N COURT ST
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-6614
Practice Address - Country:US
Practice Address - Phone:301-304-7108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-16
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701008409101YM0800X
MDLC10183101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health