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General NPI Number Information
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NPI Number | 1033683461
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Entity Type | Individual
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Provider Name | STEPHANIE LYNN GURKA LCPC
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Gender | Female
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Dates
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Enumeration Date | 01/18/2019
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Last Update Date | 06/23/2023
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Provider Practice Location Address
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Address Line | 2 HAMILL RD
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City | BALTIMORE
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State | MD
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Zip | 21210-1806
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Country | US
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Telephone | 617-531-1559
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Fax |
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Provider Business Mailing Address
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Address Line | 6636 BLACKHEAD RD
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City | MIDDLE RIVER
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State | MD
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Zip | 21220-1213
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Country | US
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Telephone | 240-906-3517
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LC7906
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License Number State | MD
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