Individual provider Active NPI

Kerry Kathleen McCommons, LCPC

  • Professional Counselor
  • Elkton, MD
National Provider Identifier
1780914796
Registry record updated Jan 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LC3450 Issued in MD
Practice address
200 Booth St
Elkton, MD 21921-5657
Phone
(443) 350-3260
Fax
(410) 939-8748
NPI assigned
Jan 14, 2010
Last updated
Jan 26, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LC3450 MD Primary

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 1

  • Ms. Kerry Tompkins Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240321001675 MD Practitioner - Mental Health Counselor 6204273642 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC3450MDMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Upper Bay Counseling and Support Services, Inc CurrentSince Jan 29, 2024 Accepting new patients
Upper Bay Counseling & Support Services, Inc. Current Accepting new patients
Rising Wellness Counseling LLC CurrentSince Mar 1, 2025 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

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1263427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485388800000",
    "number": "1780914796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 KINTYRE CT",
            "city": "TOWNSEND",
            "state": "DE",
            "postal_code": "197342864",
            "telephone_number": "302-222-0065",
            "fax_number": "410-939-8748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 BOOTH ST",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219215657",
            "telephone_number": "443-350-3260",
            "fax_number": "410-939-8748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOMMONS",
        "first_name": "KERRY",
        "middle_name": "KATHLEEN",
        "name_prefix": "Mrs.",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-14",
        "last_updated": "2017-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC3450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KERRY",
            "last_name": "TOMPKINS",
            "prefix": "MS.",
            "credential": "LGPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Elkton, MD

Sources for this page

Verify at the official NPI Registry.