Jernae Dickens-Brown

Individual provider Active NPI Mental Health Counselor · Washington, DC

NPI 1235601337 · NPPES record last updated Nov 12, 2022

Key facts

NPI
1235601337
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
PRC200001390 (DC)
Practice address
1050 30TH St NW # 107
Washington, DC 20007-3822
Phone
(301) 640-0300
NPI assigned
Dec 30, 2018
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PRC200001390DCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
N.E. Beautiful Mind, LLC Current
since Nov 13, 2022
Accepting new patients

Locations

1050 30th St NW
#107
Washington, DC 20007
Phone (301) 640-0300

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X PRC200001390 DC
Mental Health Counselor 101YM0800X PRC200001390 DC Yes

Addresses

Primary practice location

1050 30TH St NW # 107
Washington, DC 20007-3822

Mailing address

3210 Winterbourne Dr
Upper Marlboro, MD 20774-9084
Phone (302) 640-0300

Other providers in Washington, DC

All providers in Washington, DC · Mental Health Counselor in District of Columbia

Sources for this page

Verify at the official NPI Registry.