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General NPI Number Information
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NPI Number | 1487676524
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Entity Type | Organization
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Legal Business Name | CHESTER RIVER BEHAVIORAL HEALTH, LLC
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 03/16/2017
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Provider Practice Location Address
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Address Line | 952 WASHINGTON AVE SUITE 500
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City | CHESTERTOWN
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State | MD
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Zip | 21620-3322
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Country | US
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Telephone | 410-778-5550
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Fax | 410-778-0984
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Provider Business Mailing Address
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Address Line | 952 WASHINGTON AVE SUITE 500
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City | CHESTERTOWN
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State | MD
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Zip | 21620-3322
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Country | US
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Telephone | 410-778-5550
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Fax | 410-778-0984
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Authorized Official
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Title or Position | MEMBER/PARTNER
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Name | DR. TERESA INGRAM SCHAEFER
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Credential | PHD
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Telephone | 410-778-5550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LC4278
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LC6557
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LC0691
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License Number State | MD
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Taxonomy #4
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 01371
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License Number State | MD
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Taxonomy #5
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 05728
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License Number State | MD
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Taxonomy #6
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 03590
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License Number State | MD
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Taxonomy #7
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 02571
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License Number State | MD
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Taxonomy #8
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 04572
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License Number State | MD
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Taxonomy #9
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 19033
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License Number State | MD
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Taxonomy #10
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 02027
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License Number State | MD
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