Jaclyn M Altebrando, LGPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LGP12023 Issued in MD

Practice address

1206 York Rd Ste 202
Lutherville, MD 21093-6217

Phone

(443) 718-0496

NPI assigned

Oct 15, 2021

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

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": "1634256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634256000000",
    "number": "1558024752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 W 32ND ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212112705",
            "telephone_number": "908-347-8427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1206 YORK RD STE 202",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210936217",
            "telephone_number": "443-718-0496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALTEBRANDO",
        "first_name": "JACLYN",
        "middle_name": "M",
        "credential": "LGPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-15",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LGP12023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Lutherville, MD
• Providers in Lutherville, 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 Oct 15, 2021; 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.