Jennifer Stachowiak, LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LC8269 Issued in MD

Practice address

139 N Main St
Bel Air, MD 21014-8843

Phone

(443) 567-7037

NPI assigned

Feb 29, 2016

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Jennifer Thacker Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1456704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566864000000",
    "number": "1275993594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 N MAIN ST",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210148843",
            "telephone_number": "443-567-7037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 N MAIN ST",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210148843",
            "telephone_number": "443-567-7037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACHOWIAK",
        "first_name": "JENNIFER",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-29",
        "last_updated": "2019-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC8269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "THACKER",
            "credential": "LGPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Usha Srinivasan, MD
• SSC Bel Air Operating Company LLC (Bel Air Health and Rehabilitation Center)
• St Paul Place Specialists, Inc.
• St. Agnes Healthcare, Inc.
• Victoria D St.Mire, COTA
• Noel Stallmann, CRNP
• Charles David Stancliff, D.P.M.
• Julie Stancliff, DO
• Michael Stangroom, DPT
• Kayla Louise Stansberry, LCPC

• Mental Health Counselor in Bel Air, MD
• Providers in Bel Air, MD by specialty
• Mental Health Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.