Healthcare Provider Details

I. General information

NPI: 1982397550
Provider Name (Legal Business Name): ST. MARY'S COUNTY HEALTH DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2023
Last Update Date: 06/05/2023
Certification Date: 06/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21625 GREAT MILLS RD
LEXINGTON PARK MD
20653-1239
US

IV. Provider business mailing address

PO BOX 316
LEONARDTOWN MD
20650-0316
US

V. Phone/Fax

Practice location:
  • Phone: 301-904-8949
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MEENAKSHI GARG BREWSTER
Title or Position: HEALTH OFFICER
Credential:
Phone: 301-475-4317