Provider Demographics
NPI:1538725452
Name:GERRARD, MARY KATHERINE (PHD)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:KATHERINE
Last Name:GERRARD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1211 S CONKLING ST APT 356
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-5346
Mailing Address - Country:US
Mailing Address - Phone:513-319-4889
Mailing Address - Fax:
Practice Address - Street 1:9810 PATUXENT WOODS DR STE F
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-1595
Practice Address - Country:US
Practice Address - Phone:443-923-3871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-16
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
MD07383103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator