MS. JACQUELINE DALE GRANTLAND (NPI# 1316905524) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316905524 |
| Entity Type | Individual |
| Full Name | MS. JACQUELINE DALE GRANTLAND |
| Credential | LCPC, NCC |
| Practice Address |
21945 Three Notch Rd Ste 103 Lexington Park MD 20653-1563 |
| Mailing Address |
Po Box 1662 Lexington Park MD 20653-1662 |
| Practice Telephone | 3018638460 |
| Practice Fax Number | 2407181906 |
| Mailing Telephone | 3018638460 |
| Mailing Fax Number | 2407181906 |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2015-05-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
LC4189 | MD | Behavioral Health & Social Service Providers |
| N | 101YM0800X |
Counselor Specialization: Mental Health |
5199 | NC | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 6103219 | 05 |
| Street Address |
21945 THREE NOTCH RD STE 103 |
| City | LEXINGTON PARK |
| State | MD |
| Zip Code | 20653-1563 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386258929 | Suzette Jones | Nurse Practitioner | Chesapeake Shores Nursing Home, 21412 Great Mills Road, Lexington Park, MD 20653 | 2020-09-01 |
| 1659910214 | Shannon Dawn Morley | Family Medicine | 45870 E Run Dr, Lexington Park, MD 20653 | 2019-12-31 |
| 1366080533 | Crystal Lynn Bradford | Counselor | 21770 Fdr Blvd., Lexington Park, MD 20653 | 2019-12-18 |
| 1205487584 | Paulette Tyrone Scriber | Technician | 20286 Scriber Ln, Lexington Park, MD 20653 | 2019-09-26 |
| 1073162103 | Bambii Kreal | Counselor | 21770 Franklin Delano Roosevelt Blvd, Lexington Park, MD 20653 | 2019-09-11 |
| 1376039479 | Arianna Marie Day | Social Worker | 21789 N Coral Drive - Ste 2a, Bowes and Associates Psychotherapy LLC, Lexington Park, MD 20653 | 2018-07-02 |
| 1982032694 | Trico Clinical Services, Ltd | Clinic/Center | 46707 S. Shangri La Drive, Lexington Park, MD 20653 | 2013-10-16 |
| 1891047726 | Axis Healthcare Group | Social Worker | 45870 East Run Drive, Lexington Park, MD 20653 | 2012-10-02 |
| 1013164466 | Denise Owens Mullinix | Dentist | 22749 Maple Road, Lexington Park, MD 20653 | 2008-08-27 |
| 1548440555 | Trico Clinical Services, Ltd | Counselor | 46940 S. Shangri La Drive, Lexington Park, MD 20653 | 2007-11-07 |
| Find all providers in zip 20653 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912540550 | Kathleen Ann Otero | Counselor | 47870 Piney Orchard St, Lexington Park, MD 20653-4551 | 2019-10-27 |
| 1689120883 | Pathways Inc | Counselor | 21155 Lexwood Dr Ste D, Lexington Park, MD 20653-4385 | 2016-08-28 |
| 1164975405 | Amanda Mullins | Counselor | 21155 Lexwood Dr, Suite C, Lexington Park, MD 20653-4385 | 2016-08-03 |
| 1770903213 | Bowes and Associates Psychotherapy, LLC | Counselor | 21789 N Coral Dr, Suite 2a, Lexington Park, MD 20653-5517 | 2014-04-23 |
| 1710303573 | Inner Peace Therapeutic Services, LLC | Counselor | 21855 Three Notch Rd, Lexington Park, MD 20653-1564 | 2014-03-17 |
| 1881929008 | Ursula Towles | Counselor | 22776 Three Notch Rd Ste 202, Lexington Park, MD 20653-3370 | 2009-10-06 |
| 1548440555 | Trico Clinical Services, Ltd | Counselor | 46940 S. Shangri La Drive, Lexington Park, MD 20653 | 2007-11-07 |
| 1770550303 | M B Haugaard | Counselor | 46922 S Shangri La Dr, 2nd Floor, Lexington Park, MD 20653-4036 | 2006-03-02 |
| 1295708105 | Deborah Finer Feldman | Counselor | 21770 Fdr Boulevard, Lexington Park, MD 20653 | 2006-02-10 |
| 1114990173 | William E Arick | Counselor | 46940 South Shangri-la Drive, Lexington Park, MD 20653 | 2006-02-09 |
| Find all providers in LEXINGTON PARK | ||||
| City | LEXINGTON PARK |
| Zip Code | 20653 |
Please comment or provide details below to improve the information on MS. JACQUELINE DALE GRANTLAND.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.