NPIMap

Organization Active NPI

Jesse Fairchild LLC

Doing business as Bodhi

  • Mental Health Counselor
  • North East, MD
National Provider Identifier
1467724013
Registry record updated Jan 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LC2857 Issued in MD
Legal business name
JESSE FAIRCHILD LLC
Doing business as
Bodhi
Bodhi Counseling
Practice address
2057 Pulaski Hwy Ste 4
North East, MD 21901-3744
Phone
(443) 877-4044
Fax
(443) 967-0077
NPI assigned
Jan 29, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2026

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

Authorized official

Name
Janice Leslie Fairchild Chavero
Title
Practice Owner
Phone
(443) 877-4044

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X LC2857 MD Primary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X
Art TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 221700000X

Addresses

Primary practice location

2057 Pulaski Hwy Ste 4
North East, MD 21901-3744

Mailing address

2057 Pulaski Hwy Ste 4
North East, MD 21901-3744
Phone (443) 877-4044

Other names 2

  • Bodhi Doing business as
  • Bodhi Counseling Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150318000988 MD Part B Supplier - Clinic/Group Practice 7719204460 Receives reassigned benefits from 6 practitioners
Practice locations: North East, MD

National Provider Directory

National Provider Directory

Locations

2057 Pulaski Hwy
Ste 4
North East, MD 21901
Phone (443) 877-4044

2327 Pulaski Hwy
Ste 101B
North East, MD 21901

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1327795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768003200000",
    "number": "1467724013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2057 PULASKI HWY STE 4",
            "city": "NORTH EAST",
            "state": "MD",
            "postal_code": "219013744",
            "telephone_number": "443-877-4044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2057 PULASKI HWY STE 4",
            "city": "NORTH EAST",
            "state": "MD",
            "postal_code": "219013744",
            "telephone_number": "443-877-4044",
            "fax_number": "443-967-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JESSE FAIRCHILD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-29",
        "last_updated": "2026-01-10",
        "certification_date": "2026-01-10",
        "status": "A",
        "authorized_official_last_name": "FAIRCHILD CHAVERO",
        "authorized_official_first_name": "JANICE",
        "authorized_official_middle_name": "LESLIE",
        "authorized_official_title_or_position": "PRACTICE OWNER",
        "authorized_official_telephone_number": "443-877-4044"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC2857",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "221700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Art Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bodhi",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bodhi",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bodhi Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North East, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.