MEDICARE: KATHRYN OMERSO, LCSW-C, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1588511893
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KATHRYN OMERSO, LCSW-C, LLC

Provider Business Mailing Address
First Line	:	1705 ROSEMONT AVE
Second Line	:
City	:	FREDERICK
State	:	MD
Zip	:	21702-4135
Country	:	US
Telephone Number	:	240-366-1115
Fax Number	:

Provider Business Practice Location Address
First Line	:	1705 ROSEMONT AVE
Second Line	:
City	:	FREDERICK
State	:	MD
Zip	:	21702-4135
Country	:	US
Telephone Number	:	240-366-1115
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KATHRYN OMERSO
Credential	:	LCSW-C
Telephone Number	:	240-899-2089

Provider Enumeration Date	:	03/16/2026
Last Update Date	:	03/16/2026

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