Ms Janice Leslie Fairchild, MS | |
500 S Main St, Suite 101b, North East, MD 21901-3920 | |
(443) 877-4044 | |
(443) 505-7065 |
Full Name | Ms Janice Leslie Fairchild |
---|---|
Gender | Female |
Speciality | Counselor - Professional |
Location | 500 S Main St, North East, Maryland |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1164620043 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | LC2857 (Maryland) | Primary |
Entity Name | Jesse Fairchild Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1467724013 PECOS PAC ID: 7719204460 Enrollment ID: O20150318000988 |
Mailing Address | Practice Location Address |
---|---|
Ms Janice Leslie Fairchild, MS 500 S Main St, North East, MD 21901-3920 Ph: (443) 877-4044 | Ms Janice Leslie Fairchild, MS 500 S Main St, Suite 101b, North East, MD 21901-3920 Ph: (443) 877-4044 |
Mark Mathews, MA, LGPC, NCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 102 E Cecil Ave Ste D, North East, MD 21901 Phone: 484-849-1068 | |
Susanna Stapleford, LGPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2057 Pulaski Hwy, North East, MD 21901 Phone: 443-877-4044 | |
Gail Johnson-miller, Counselor Medicare: Not Enrolled in Medicare Practice Location: 206 Mechanics Valley Rd, North East, MD 21901 Phone: 410-893-4600 Fax: 410-569-0094 | |
Alakeisha Patterson, LGPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 106 Steamboat Ct, North East, MD 21901 Phone: 240-917-8173 | |
Ryan Aidan Lundergan, LGPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2057 Pulaski Hwy Ste 4, North East, MD 21901 Phone: 443-877-4044 | |
Kasey Lynn Seltner, LGPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2057 Pulaski Hwy Ste 4, North East, MD 21901 Phone: 443-877-4044 |