Provider Demographics
NPI:1730983339
Name:NOVICK, JENNIFER M (EDM)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:M
Last Name:NOVICK
Suffix:
Gender:F
Credentials:EDM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17710 BISHOPS CASTLE CT
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-1638
Mailing Address - Country:US
Mailing Address - Phone:732-614-8169
Mailing Address - Fax:
Practice Address - Street 1:17710 BISHOPS CASTLE CT
Practice Address - Street 2:
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-1638
Practice Address - Country:US
Practice Address - Phone:732-614-8169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-02
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool