Provider Demographics
NPI:1033294541
Name:KAHL, MARY M (LCPC)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:M
Last Name:KAHL
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2442 WYNFIELD COURT
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-3144
Mailing Address - Country:US
Mailing Address - Phone:301-694-8138
Mailing Address - Fax:301-668-6028
Practice Address - Street 1:2442 WYNFIELD COURT
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-3144
Practice Address - Country:US
Practice Address - Phone:301-694-8138
Practice Address - Fax:301-668-6028
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC1653101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional