Individual
MRS. KELEIGH DAWN KONGKRAPHUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
44 E GORDON ST, BEL AIR, MD 21014-2916
(410) 838-9000
(410) 838-8953
Mailing address
1548 SUNSWEPT DR, BEL AIR, MD 21015-5023
(443) 604-4341
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LC1774
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10012610
APS HEALTHCARE
MD
01
—
276938
COMPSYCH
MD
01
—
889318-01
CAREFIRST BCBS
MD
01
—
T541-0073
CAREFIRST BCBS
MD
Enumeration date
07/07/2006
Last updated
07/09/2007
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