Provider Demographics
NPI:1881083301
Name:CERKAN, CAROL-ANN MARIE (LCPC)
Entity type:Individual
Prefix:
First Name:CAROL-ANN
Middle Name:MARIE
Last Name:CERKAN
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 1:5820 YORK RD STE T300
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21212-3622
Mailing Address - Country:US
Mailing Address - Phone:410-989-3899
Mailing Address - Fax:410-777-8742
Practice Address - Street 1:5820 YORK RD STE T300
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21212-3622
Practice Address - Country:US
Practice Address - Phone:410-989-3899
Practice Address - Fax:410-777-8742
Is Sole Proprietor?:No
Enumeration Date:2015-01-21
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC3458101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional