Healthcare Provider Details

I. General information

NPI: 1154972586
Provider Name (Legal Business Name): CALVERT COUNTY HEALTH DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2019
Last Update Date: 09/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9010 CHESAPEAKE AVENUE
NORTH BEACH MD
20714
US

IV. Provider business mailing address

PO BOX 980
PRINCE FREDERICK MD
20678-0980
US

V. Phone/Fax

Practice location:
  • Phone: 410-257-2549
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DORIS JEAN MCDONALD
Title or Position: DIRECTOR
Credential: LCPC
Phone: 410-535-3079