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NPI Code Detail

MEDICARE: MR. KENNETH DAVID PHILLIPS M.S.

MEDICARE: MR. KENNETH DAVID PHILLIPS M.S.
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
1101YP1600XPastoral Counselor

General Provider Information

NPI Number : 1871867119
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. KENNETH DAVID PHILLIPS M.S.
Provider Business Mailing Address
First Line : 8901 NEW HAMPSHIRE AVE
Second Line :
City : SILVER SPRING
State : MD
Zip : 20903-3611
Country : US
Telephone Number : 301-422-5423
Fax Number : 301-422-5416
Provider Business Practice Location Address
First Line : 8901 NEW HAMPSHIRE AVE
Second Line :
City : SILVER SPRING
State : MD
Zip : 20903-3611
Country : US
Telephone Number : 301-422-5423
Fax Number : 301-422-5416
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2012
Last Update Date : 01/25/2026

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