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NPI Code Detail

MEDICARE: CHANNEL MARKER, INC

MEDICARE: CHANNEL MARKER, INC
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
1251S00000XCommunity/Behavioral Health Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1487832929
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHANNEL MARKER, INC
Provider Business Mailing Address
First Line : 8865 GLEBE PARK DR
Second Line : UNIT 1
City : EASTON
State : MD
Zip : 21601-7003
Country : US
Telephone Number : 410-822-4619
Fax Number :
Provider Business Practice Location Address
First Line : 508 KERR AVE
Second Line :
City : DENTON
State : MD
Zip : 21629-1343
Country : US
Telephone Number : 410-479-2318
Fax Number :
Authorized Official
Title or Position : PROGRAM DIRECTOR
Name : CATHERINE CASSELL
Credential : LCSW-C
Telephone Number : 410-822-4619
Provider Enumeration Date : 02/07/2008
Last Update Date : 12/20/2016

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Directions to “CHANNEL MARKER, INC ” Practice Location

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