Healthcare Provider Details

I. General information

NPI: 1396014429
Provider Name (Legal Business Name): HARFORD COUNTY HEALTH DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2011
Last Update Date: 01/17/2020
Certification Date: 01/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 S HAYS ST
BEL AIR MD
21014-3615
US

IV. Provider business mailing address

120 S HAYS ST
BEL AIR MD
21014-3615
US

V. Phone/Fax

Practice location:
  • Phone: 410-877-1033
  • Fax:
Mailing address:
  • Phone: 410-877-1033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: MARCY R AUSTIN
Title or Position: DEPUTY HEALTH OFFICER
Credential:
Phone: 410-877-1033