MEDICARE: KITT LENA KLASSEN LGPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	LGP13120	MD

General Provider Information

NPI Number	:	1154044774
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KITT LENA KLASSEN LGPC

Provider Business Mailing Address
First Line	:	319 W PATRICK ST
Second Line	:
City	:	FREDERICK
State	:	MD
Zip	:	21701-4855
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3448 ELLICOTT CENTER DR
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21043-4171
Country	:	US
Telephone Number	:	202-731-0811
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2022
Last Update Date	:	09/20/2022

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Directions to “ KITT LENA KLASSEN LGPC” Practice Location

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