Provider Demographics
NPI:1891337838
Name:DEIGNAN-KOSMIDES, JEANNE (LCPC)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:
Last Name:DEIGNAN-KOSMIDES
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 1:3701 OLD COURT RD STE 3B
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-3901
Mailing Address - Country:US
Mailing Address - Phone:410-952-9173
Mailing Address - Fax:
Practice Address - Street 1:3701 OLD COURT RD STE 3B
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-3901
Practice Address - Country:US
Practice Address - Phone:410-952-9173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-10
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC9943101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor