Provider Demographics
NPI:1043327646
Name:MARIA, KSANTI (LPC)
Entity Type:Individual
Prefix:
First Name:KSANTI
Middle Name:
Last Name:MARIA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:
Other - Last Name:GASKILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC MHSP
Mailing Address - Street 1:24 BEAVER RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MORRIS PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07950-1901
Mailing Address - Country:US
Mailing Address - Phone:615-430-5746
Mailing Address - Fax:
Practice Address - Street 1:24 BEAVER RIDGE RD
Practice Address - Street 2:
Practice Address - City:MORRIS PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07950-1901
Practice Address - Country:US
Practice Address - Phone:615-430-5746
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00619100101YP2500X
TNLPC1736101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ37PC00619100OtherNJ LPC LICENSE
89505OtherNBCC NATIONAL LICENSE
TNLPC1736OtherTN LPC LICENSE