Healthcare Provider Details

I. General information

NPI: 1952060246
Provider Name (Legal Business Name): KELSEY L ROOD LGPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2021
Last Update Date: 08/13/2024
Certification Date: 08/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

845 QUINCE ORCHARD BLVD STE F
GAITHERSBURG MD
20878-1676
US

IV. Provider business mailing address

13 GAINFORD CT
OLNEY MD
20832-1660
US

V. Phone/Fax

Practice location:
  • Phone: 301-769-5878
  • Fax:
Mailing address:
  • Phone: 301-575-7697
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLGP11886
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: