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General NPI Number Information
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NPI Number | 1780914796
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Entity Type | Individual
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Provider Name | KERRY KATHLEEN MCCOMMONS LCPC
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Gender | Female
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Dates
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Enumeration Date | 01/14/2010
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Last Update Date | 01/26/2017
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Provider Practice Location Address
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Address Line | 200 BOOTH ST
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City | ELKTON
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State | MD
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Zip | 21921-5657
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Country | US
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Telephone | 443-350-3260
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Fax | 410-939-8748
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Provider Business Mailing Address
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Address Line | 17 KINTYRE CT
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City | TOWNSEND
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State | DE
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Zip | 19734-2864
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Country | US
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Telephone | 302-222-0065
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Fax | 410-939-8748
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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 | LC3450
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License Number State | MD
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