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KEVIN M. BERGSTROM LCPC
NPI 1457863748
Counselor - Professional in Fulton, MD

Active since October 26, 2017
12350 HALL SHOP RD, FULTON, MD 20759(800) 491-5369(301) 774-3678 Get Directions Write a Review

NPPES record last updated: October 26, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kevin M. Bergstrom Lcpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KEVIN M. BERGSTROM LCPC (NPI 1457863748) is an individual professional provider in Fulton, Maryland, licensed in Maryland (LC7780) and active in the NPI registry since October 2017.

NPPES Registry Identity

NPI1457863748
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameKEVIN M. BERGSTROMCredential: LCPC
Location Address12350 HALL SHOP RDFulton, MD 20759-9774
Mailing AddressPo Box 339Ashton, MD 20861-0339 · (800) 491-5369 · Fax (301) 774-3678
Phone(800) 491-5369
Fax(301) 774-3678
Sole ProprietorYes
Enumeration DateOctober 26, 2017
✔ NPI 1457863748 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in MD · LC7780
12350 HALL SHOP RD, Fulton, MD 20759
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Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PAMELA KO
Counselor
12350 HALL SHOP RD
FULTON, MD 20759
Howard County (301) 318-7147
LEANNE STAYLOR
Counselor (Professional)
12350 HALL SHOP RD
FULTON, MD 20759
Howard County (443) 267-6038
CENTREPOINTE COUNSELING, INC.
Counselor (Pastoral)
12350 HALL SHOP RD
FULTON, MD 20759
Howard County (800) 491-5369

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kevin Bergstrom's NPI number?

The NPI number for Kevin Bergstrom is 1457863748. It was assigned to this individual provider in the NPPES registry on October 26, 2017.

Where is Kevin Bergstrom located?

Kevin Bergstrom practices at 12350 Hall Shop Rd, Fulton, MD 20759. The listed phone number is (800) 491-5369.

What is Kevin Bergstrom's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

When was this NPI record last updated?

The NPPES record for Kevin Bergstrom was last updated on October 26, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.