MEDICARE: MRS. KATHERINE ANN BONINCONTRI LCPC

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	101YM0800X	Mental Health Counselor	LC2400	MD

General Provider Information

NPI Number	:	1962680645
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KATHERINE ANN BONINCONTRI LCPC

Provider Business Mailing Address
First Line	:	PO BOX 180
Second Line	:
City	:	ODENTON
State	:	MD
Zip	:	21113-0180
Country	:	US
Telephone Number	:	410-975-0067
Fax Number	:	410-975-0204

Provider Business Practice Location Address
First Line	:	741 ANNAPOLIS RD
Second Line	:
City	:	GAMBRILLS
State	:	MD
Zip	:	21054-1308
Country	:	US
Telephone Number	:	410-975-0067
Fax Number	:	410-975-0204

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/05/2008
Last Update Date	:	01/09/2026

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