Healthcare Provider Details

I. General information

NPI: 1861514697
Provider Name (Legal Business Name): MONTGOMERY COUNTY MARYLAND GOVERNMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 E GUDE DR
ROCKVILLE MD
20850-5307
US

IV. Provider business mailing address

401 HUNGERFORD DR FL 6TH
ROCKVILLE MD
20850-4154
US

V. Phone/Fax

Practice location:
  • Phone: 240-777-1444
  • Fax:
Mailing address:
  • Phone: 240-777-2500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code261QP0905X
TaxonomyState or Local Public Health Clinic/Center
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: DIANA AZUCENA CORTEZ
Title or Position: MANAGEMENT
Credential:
Phone: 240-672-6758