Organization · NPI-2

Andrew T. Gergely, M.D.,l.C.C.

Counselor, Professional · Edgewater, MD

NPI number1326585076
StatusActive
Last updated in NPPESJan 19, 2017

Details

NPI
1326585076
Entity type
Organization (NPI-2)
Legal business name
Andrew T. Gergely, M.D.,l.C.C.
Organization subpart
No
Enumeration date
Jan 19, 2017
Last updated
Jan 19, 2017

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YP2500X Counselor, ProfessionalLC0630MDYes
101YP2500X Counselor, ProfessionalLC1239MD
101YP2500X Counselor, ProfessionalLC6770MD
1041C0700X Social Worker, Clinical09927MD
1041C0700X Social Worker, Clinical03914MD
1041C0700X Social Worker, Clinical12303MD
2084P0800X Psychiatry & Neurology, PsychiatryD43972MD

Practice location

137 Mitchells Chance Rd
260
Edgewater, MD 21037-2787

Phone 410-956-5300 · Fax 410-956-5301

Mailing address

3175 W Ward Rd
200
Dunkirk, MD 20754-3020

Phone 410-286-0664 · Fax 410-286-2834

Authorized official

Phylis Mccullough
Office Manager
4102860664

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