Jewna Bonita Ehlke, LCPC, LPC, LPC
Individual provider Active NPI Professional Counselor · Suitland, MD
NPI 1679092019 · NPPES record last updated Mar 13, 2024
Key facts
- NPI
- 1679092019
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- LC7692 (MD)
- Practice address
- 5100 Auth Way
Suitland, MD 20746-4276 - Phone
- (301) 782-5084
- NPI assigned
- Sep 18, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in DC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240322000530 | DC | Practitioner - Mental Health Counselor | 0345687653 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaiser Foundation Health Plan of the Mid Atlantic States, Inc | Current |
Accepting new patients | |
| Kaiser Foundation Health Plan of the Mid Atlantic States, Inc | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of the Mid Atlantic States, Inc | Current |
Accepting new patients |
Locations
2101 E Jefferson St
Ste 6WPPQA
Rockville, MD 20852
Phone (301) 816-5853
5100 Auth Way
Suitland, MD 20746
Phone (301) 702-5000
1221 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 618-5500
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LC7692 | MD | Yes |
| Clinical Social Worker | 1041C0700X | LC7692 | MD |
Addresses
Primary practice location
5100 Auth Way
Suitland, MD 20746-4276
Mailing address
5100 Auth Way
Suitland, MD 20746-4276
Phone (301) 782-5084
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways | ||
| SOAP URL | https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq | Health Information Exchange (HIE) |
Other providers in Suitland, MD
- Keyante Jaqua Dixon
- Johnny Patrick Dotson Jr.
- Dr.Roh & Shin'S Clinic
- Cydney Monet Dyson
- Alana Eason Wilhite
- Ejw Enterprises Dba the Delicate Doula
- Ada Ukpai Emarievbe
- Roseline Endjieu
- Endocrine & Diabetes Group of Washington, PC
- Victorine Engowei
All providers in Suitland, MD · Professional Counselor in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 13, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.