Healthcare Provider Details

I. General information

NPI: 1497126908
Provider Name (Legal Business Name): HOWARD COUNTY HEALTH DEPARTMENT, BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2015
Last Update Date: 10/17/2022
Certification Date: 10/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8930 STANFORD BLVD
COLUMBIA MD
21045
US

IV. Provider business mailing address

8930 STANFORD BLVD
COLUMBIA MD
21045
US

V. Phone/Fax

Practice location:
  • Phone: 410-313-6202
  • Fax:
Mailing address:
  • Phone: 410-313-6202
  • Fax: 410-313-6212

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License Number13894
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CARLETTA MCKNIGHT
Title or Position: FINANCE DIRECTOR
Credential:
Phone: 410-313-6300