Healthcare Provider Details

I. General information

NPI: 1851233555
Provider Name (Legal Business Name): ERNEST BENEDICT KESSY JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2026
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1508 DECEMBER DR
SILVER SPRING MD
20904-3614
US

IV. Provider business mailing address

1508 DECEMBER DR
SILVER SPRING MD
20904-3614
US

V. Phone/Fax

Practice location:
  • Phone: 301-532-9059
  • Fax: 301-532-9059
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberMD-10273359207
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: