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NPI Code Detail

MEDICARE: CHESAPEAKE CHURCH

MEDICARE: CHESAPEAKE CHURCH
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
1101Y00000XCounselor
21041C0700XClinical Social Worker

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1LP57OTHERMDCAREFIRST BC/BS
2F453OTHERMDCAREFIRST BLUECHOICE

General Provider Information

NPI Number : 1396747358
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHESAPEAKE CHURCH
Provider Business Mailing Address
First Line : 6045 SOLOMONS ISLAND RD
Second Line :
City : HUNTINGTOWN
State : MD
Zip : 20639-8876
Country : US
Telephone Number : 410-257-5200
Fax Number : 410-257-2442
Provider Business Practice Location Address
First Line : 6045 SOLOMONS ISLAND RD
Second Line :
City : HUNTINGTOWN
State : MD
Zip : 20639-8876
Country : US
Telephone Number : 410-257-5200
Fax Number : 410-257-2442
Authorized Official
Title or Position : MANAGING DIRECTOR
Name : MRS. ROBIN BRUNGARD
Credential : LCSW-C
Telephone Number : 410-257-5200
Provider Enumeration Date : 06/02/2005
Last Update Date : 03/05/2008

Similar Medicare Providers

1851396220 — APRIL DAWN MORRISSEY LCSW-C
Practice Location Address:
6045 SOLOMONS ISLAND RD
HUNTINGTOWN, MD
20639-8876
Practice Phone: 410-257-5200
Practice Fax: 410-257-2442
1215932678 — DR. MICHAEL K LEA PHD, PSYD
Practice Location Address:
6045 SOLOMONS ISLAND RD
HUNTINGTOWN, MD
20639-8876
Practice Phone: 410-257-5200
Practice Fax: 410-257-2442
1225033400 — ROBERT E JONES JR. LCSW
Practice Location Address:
6045 SOLOMONS ISLAND RD
HUNTINGTOWN, MD
20639-8876
Practice Phone: 410-257-5200
Practice Fax: 410-257-2442
1922021658 — MARY ELIZABETH SWIERINGA LCSW-C
Practice Location Address:
6045 SOLOMONS ISLAND RD
HUNTINGTOWN, MD
20639-8876
Practice Phone: 410-257-5200
Practice Fax: 410-257-2442
1053529560 — MRS. MARIA H WHEDBEE LCSW-C, LGSW
Practice Location Address:
6045 SOLOMONS ISLAND RD
HUNTINGTOWN, MD
20639-8876
Practice Phone: 410-257-5200
Practice Fax: 410-257-2442
1861684805 — MRS. WANDA MARIE BARNES LCSW-C
Practice Location Address:
6045 SOLOMONS ISLAND RD
HUNTINGTOWN, MD
20639-8876
Practice Phone: 410-257-5200
Practice Fax: 410-257-2442

Directions to “CHESAPEAKE CHURCH ” Practice Location

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