Provider Demographics
NPI:1275832750
Name:KERSHESKEY, STEPHANIE L (LCPC)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:L
Last Name:KERSHESKEY
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 1:2963 HALSTON DR
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:MD
Mailing Address - Zip Code:21102-1811
Mailing Address - Country:US
Mailing Address - Phone:443-791-5264
Mailing Address - Fax:
Practice Address - Street 1:181 EAST MAIN STREET
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-2115
Practice Address - Country:US
Practice Address - Phone:443-791-5264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-23
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC3871101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional