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NPI Code Detail

MEDICARE: KATHARINA VON GERSDORFF LCPC

MEDICARE:   KATHARINA  VON GERSDORFF  LCPC
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
1101YM0800XMental Health CounselorLC5986MD

General Provider Information

NPI Number : 1538535208
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHARINA VON GERSDORFF LCPC
Provider Business Mailing Address
First Line : 12720 ESWORTHY RD
Second Line :
City : NORTH POTOMAC
State : MD
Zip : 20878-8707
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5840 BANNEKER RD
Second Line :
City : COLUMBIA
State : MD
Zip : 21044-3103
Country : US
Telephone Number : 410-730-2385
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2015
Last Update Date : 08/18/2015

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Directions to “ KATHARINA VON GERSDORFF LCPC” Practice Location

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