Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1861920282 Individual Practitioner Female Practitioner

Jacqueline Ejim , LCPC

Counselor - Professional • Baltimore, MD

Professional Overview & Biography Verified Profile Summary

Jacqueline Ejim, LCPC is a registered healthcare professional specializing in Counselor - Professional in Baltimore, MD. Practice services are available at 1040 PARK AVE STE 200 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1040 Park Ave Ste 200

Baltimore, MD 212015634

Telephone 4437380300
Fax 4437380301
Associated Practice Facility / Clinic
🏢 Baltimore Medical System Inc Facility NPI 1851817431

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor - Professional in Baltimore, MD

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 14.7 Yrs
State Avg: 17.2 Yrs
Regional Practice Density
589 Specialists

Practicing in Baltimore, MD (4138 Statewide)

Telehealth Adoption Rate
4.1% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-10-06
Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

State License MD LC7848

Definition to come...

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

29 Associated Practitioners
Carrie Joneckis , PA-C

Physician Assistant - Medical

NPI 1013033513

Physician Assistant (Certified)

NPI 1093158560

Doctor of Medicine (M.D.)

NPI 1184641870

Doctor of Medicine (M.D.), Master of Science

Dr. Vishal Sethi , MD

Internal Medicine - Infectious Disease

NPI 1225251440

Doctor of Medicine (M.D.)

Dr. Vianca Masucci , MD

Internal Medicine

NPI 1245813781

Doctor of Medicine (M.D.)

Carol Garey , LCSW-C

Social Worker - Clinical

NPI 1366876690

Licensed Clinical Social Worker - Certified

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

12 Historical Events
📍
Updated Practice Location October 06, 2025

Registered at 1040 PARK AVE STE 200, BALTIMORE, MD 212015634 (Tel: 4437380300)

📍
Updated Business Mailing Address October 06, 2025

Registered at 1040 PARK AVE STE 200, BALTIMORE, MD 212015634 (Tel: 4437380300)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 06, 2025

Counselor (License #LC7848 in MD)

📍
Updated Business Mailing Address June 16, 2021

Registered at 6918 RIDGE RD, ROSEDALE, MD 212373854 (Tel: 4437312349)

📍
Updated Practice Location November 04, 2019

Registered at 7902 BELAIR RD, NOTTINGHAM, MD 212363707 (Tel: 4437312349)

👤
Provider Name / Credentials Updated November 04, 2019

Recorded as JACQUELINE EJIM, LCPC

NPI Profile Active May 30, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location May 30, 2017

Registered at 3238-40 BELAIR ROAD, BALTIMORE, MD 212132121 (Tel: 4104837357)

📍
Updated Business Mailing Address May 30, 2017

Registered at 1281 SUGARWOOD CIRCLE, ESSEX, MD 21221 (Tel: 4437217574)

👤
Provider Name / Credentials Updated May 30, 2017

Recorded as JACQUELINE WALLACE EJIM, LCPC

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 30, 2017

Counselor (License #LC7848 in MD)

🟢
Initial NPI Registration & Enumeration May 30, 2017

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1861920282
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 30, 2017
Last Update: October 06, 2025
Sole Proprietor: Yes

Mailing Address

1040 Park Ave Ste 200

Baltimore, MD 212015634

Phone: 4437380300

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.