Healthcare Provider Details

I. General information

NPI: 1396658928
Provider Name (Legal Business Name): CHARITY ANNE MORTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14815 MANOR RD
MONKTON MD
21111-2400
US

IV. Provider business mailing address

3430 ALBANTOWNE WAY
EDGEWOOD MD
21040-3536
US

V. Phone/Fax

Practice location:
  • Phone: 410-205-5123
  • Fax:
Mailing address:
  • Phone: 808-367-9058
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLGP18472
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: