Carol Ann McKissick, LCPC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

LGP8698 Issued in MD

Practice address

2850 N. Ridge Rd. Suite 208a
Santoro Psychological Services
Ellicott City, MD 21043

Phone

(410) 988-5943

NPI assigned

Feb 19, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1550534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650844800000",
    "number": "1851857429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 BOUNTIFUL DR",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211577530",
            "telephone_number": "443-520-4374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 N. RIDGE RD. SUITE 208A",
            "address_2": "SANTORO PSYCHOLOGICAL SERVICES",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "21043",
            "telephone_number": "410-988-5943"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3355 Saint Johns Ln Ste J",
            "address_purpose": "LOCATION",
            "city": "Ellicott City",
            "state": "MD",
            "postal_code": "210422600",
            "country_code": "US",
            "telephone_number": "443-313-5050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKISSICK",
        "first_name": "CAROL",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-19",
        "last_updated": "2022-04-25",
        "certification_date": "2022-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LGP8698",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MD",
            "license": "LGP8698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kara McCourt-Skeberdis, NCTMB
• Luverne Mercedes McDonald
• David Robert McDuff, M.D.
• Kelsey Marie McGinty, NURSE PRACTITIONER
• Kevin E McGovern, MD
• Mary McKitrick
• Chandra McKnight-Dean
• Brian McLarney
• Angie McLean, MS CCC-SLP
• Mary McMahon

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2022; 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.