Provider Demographics
NPI:1649710013
Name:KUESSNER, ERIC JR (LCSW-C)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:KUESSNER
Suffix:JR
Gender:M
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1705 CONOWINGO RD
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014
Mailing Address - Country:US
Mailing Address - Phone:443-372-8613
Mailing Address - Fax:
Practice Address - Street 1:1705 CONOWINGO RD
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-1815
Practice Address - Country:US
Practice Address - Phone:443-372-8613
Practice Address - Fax:443-625-1520
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-03
Last Update Date:2024-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22502104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker