Kerry Kathleen McCommons, LCPC
Individual provider Active NPI Professional Counselor · Elkton, MD
NPI 1780914796 · NPPES record last updated Jan 26, 2017
Key facts
- NPI
- 1780914796
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- LC3450 (MD)
- Practice address
- 200 Booth St
Elkton, MD 21921-5657 - Phone
- (443) 350-3260
- Fax
- (410) 939-8748
- NPI assigned
- Jan 14, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240321001675 | MD | Practitioner - Mental Health Counselor | 6204273642 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LC3450 | MD | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Upper Bay Counseling and Support Services, Inc | Current |
Accepting new patients | |
| Upper Bay Counseling & Support Services, Inc. | Current | Accepting new patients | |
| Rising Wellness Counseling LLC | Current |
Accepting new patients | |
| Changing Tides Therapeutic & Consultative Services, LLC | Past | Accepting new patients |
Locations
200 Booth St
Elkton, MD 21921
Phone (410) 996-3400
71 Flint Dr
North East, MD 21901
Phone (410) 620-7161
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LC3450 | MD | Yes |
Addresses
Primary practice location
200 Booth St
Elkton, MD 21921-5657
Mailing address
17 Kintyre CT
Townsend, DE 19734-2864
Phone (302) 222-0065
Other names
- Ms. Kerry Tompkins
Other providers in Elkton, MD
- Taylor Mazick
- Cynthia Mbonu
- Darren C McAuley
- Stephen McCann
- Caryn Nmi McCardell
- Anastasia Crystal McCoy
- John Anthony McCracken Jr.
- Erica McCreary
- McDonald Chiropractic, PC
- Brian Michael McDonald
All providers in Elkton, MD · Professional Counselor in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 26, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.