MEDICARE: CALVERT COUNTY HEALTH DEPARTMENT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	324500000X	Substance Abuse Rehabilitation Facility	12084	MD

General Provider Information

NPI Number	:	1215916598
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CALVERT COUNTY HEALTH DEPARTMENT

Provider Business Mailing Address
First Line	:	P.O. BOX 1158
Second Line	:
City	:	PRINCE FREDERICK
State	:	MD
Zip	:	20678
Country	:	US
Telephone Number	:	410-535-3079
Fax Number	:	410-535-2220

Provider Business Practice Location Address
First Line	:	3819 HARBOR RD.
Second Line	:	SUITE 103
City	:	CHESAPEAKE BEACH
State	:	MD
Zip	:	20732
Country	:	US
Telephone Number	:	410-286-0547
Fax Number	:	410-286-8950

Authorized Official
Title or Position	:	BEHAVIORAL HEALTH DIRECTOR
Name	:	MRS. DORIS J. MCDONALD
Credential	:	MA, LCADC, LCDC
Telephone Number	:	410-535-3079

Provider Enumeration Date	:	01/13/2006
Last Update Date	:	08/08/2023

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