Jennifer Marie Serico, M.S.

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

Practice address

1750 E Fairmount Ave
Baltimore, MD 21231-1534

Phone

(443) 923-5982

NPI assigned

Jul 3, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Locations

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.

• Kennedy Krieger Associates

  • Pediatrics Physician
  • Baltimore, MD
  • NPI 1871515783
  Medicare reassignment NPD
• Kennedy Krieger Associates

  • Pediatrics Physician
  • Middle River, MD
  • NPI 1841009842
  NPD

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

{
    "created_epoch": "1372809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372809600000",
    "number": "1447690557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 E FAIRMOUNT AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212311534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 E FAIRMOUNT AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212311534",
            "telephone_number": "443-923-5982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERICO",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-03",
        "last_updated": "2013-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Serenity Wellness Mental Health Center LLC
• Diane Serex-Dougan, O.D.
• Jacwynne Danee Sergeant
• Nikolay N Sergeevykh, LCPC
• Gary J Sergott, CRNA
• Brittany Rae Serio, L. AC
• Michael Serlin, MD
• Katherine Grace Serna, PHARMD
• Holly Lynn Sernulka, RN
• James George Serra, D.D.S.

• Clinical Child & Adolescent Psychologist in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Clinical Child & Adolescent Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.