| Jacquelyne Gordon, LCPC | |
|
2021 Chaneyville Rd Ste 102, Owings, MD 20736-4348 | |
| (410) 286-2833 | |
| (410) 286-2834 |
| Full Name | Jacquelyne Gordon |
|---|---|
| Gender | Female |
| Speciality | Mental Health Counselor |
| Experience | 25 Years |
| Location | 2021 Chaneyville Rd Ste 102, Owings, Maryland |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194913665 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | LC2279 (Maryland) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Quince Orchard Psychotherapy Llc | 5395194302 | 25 |
| Entity Name | Quince Orchard Psychotherapy Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1336670389 PECOS PAC ID: 5395194302 Enrollment ID: O20231214003799 |
| Mailing Address | Practice Location Address |
|---|---|
| Jacquelyne Gordon, LCPC Po Box 630973, Baltimore, MD 21263-0973 Ph: (410) 286-2833 | Jacquelyne Gordon, LCPC 2021 Chaneyville Rd Ste 102, Owings, MD 20736-4348 Ph: (410) 286-2833 |
Jill B. Lienhardt, L.C.P.C. Counselor Medicare: Accepting Medicare Assignments Practice Location: 2021 Chaneyville Rd, Suite 102, Owings, MD 20736 Phone: 410-286-0664 Fax: 410-286-2834 | |
Geraldine Franco Pavel, L.C.P.C.,M.A. Counselor Medicare: Accepting Medicare Assignments Practice Location: 2021 Chaneyville Rd, Suite 102, Owings, MD 20736 Phone: 410-286-0664 Fax: 410-286-2834 | |
Ms. Dee Winfild, Counselor Medicare: Not Enrolled in Medicare Practice Location: 113 E Chesapeake Beach Rd, Suite 101, Owings, MD 20736 Phone: 443-607-6207 Fax: 443-607-6208 | |
Kristina Bingham, Counselor Medicare: Not Enrolled in Medicare Practice Location: 740 Good Shepherd Way, Owings, MD 20736 Phone: 410-320-6163 | |
Amanda Peterson, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2021 Chaneyville Rd Ste 100, Owings, MD 20736 Phone: 410-610-0046 |