Provider Demographics
NPI:1679118384
Name:MARGOLIS, JAMI (LCPC)
Entity type:Individual
Prefix:
First Name:JAMI
Middle Name:
Last Name:MARGOLIS
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4785 DORSEY HALL DR STE 109
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-7862
Mailing Address - Country:US
Mailing Address - Phone:410-340-0124
Mailing Address - Fax:
Practice Address - Street 1:4785 DORSEY HALL DR STE 109
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-7862
Practice Address - Country:US
Practice Address - Phone:410-340-0124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-18
Last Update Date:2019-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC1738103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDNAOtherNA