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General NPI Number Information
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NPI Number | 1396315255
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Entity Type | Individual
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Provider Name | ERIK W KASPER SC2859
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Gender | Male
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Dates
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Enumeration Date | 07/01/2021
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Last Update Date | 07/01/2021
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Provider Practice Location Address
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Address Line | 202 COURSEVALL DR STE 104
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City | CENTREVILLE
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State | MD
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Zip | 21617-2805
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Country | US
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Telephone | 443-262-0425
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Fax |
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Provider Business Mailing Address
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Address Line | 29200 CORBIN PKWY
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City | EASTON
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State | MD
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Zip | 21601-4830
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Country | US
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Telephone | 631-335-8372
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | SC2895
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License Number State | MD
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