Kourtney T Jeffers, LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LGP11295 Issued in MD

Practice address

8090 Woodloo Dr
Ellicott City, MD 21043-6921

Phone

(336) 327-4714

NPI assigned

Nov 15, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1668470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1134838576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8090 WOODLOO DR",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210436921",
            "telephone_number": "336-327-4714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8090 WOODLOO DR",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210436921",
            "telephone_number": "336-327-4714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERS",
        "first_name": "KOURTNEY",
        "middle_name": "T",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-15",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC13750",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LGP11295",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MD",
            "identifier": "LGP11295",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Ellicott City, MD
• Providers in Ellicott City, MD by specialty
• Mental Health Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.