Active NPI
Jenae Nichelle Proctor, LCPC
- Counselor
- Upper Marlboro, MD
National Provider Identifier
1740753276
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- LC12267
- Practice address
- 9701 Apollo Dr Ste 330
Upper Marlboro, MD 20774-4795 - Phone
- (240) 487-6934
- NPI assigned
- Jan 8, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | LC12267 | MD | Primary |
Addresses
Primary practice location
9701 Apollo Dr Ste 330
Upper Marlboro, MD 20774-4795
Mailing address
9701 Apollo Dr Ste 330
Upper Marlboro, MD 20774-4795
Phone (240) 487-6934
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LC12267 | MD | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Washington Area Clinical Center, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1546905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1773964800000",
"number": "1740753276",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9701 APOLLO DR STE 330",
"city": "UPPER MARLBORO",
"state": "MD",
"postal_code": "207744795",
"telephone_number": "240-487-6934"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9701 APOLLO DR STE 330",
"city": "UPPER MARLBORO",
"state": "MD",
"postal_code": "207744795",
"telephone_number": "240-487-6934"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROCTOR",
"first_name": "JENAE",
"middle_name": "NICHELLE",
"name_prefix": "Dr.",
"credential": "LCPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-01-08",
"last_updated": "2026-03-20",
"certification_date": "2026-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "MD",
"license": "LC12267",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Upper Marlboro, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2026; 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.