NPIMap

Organization Active NPI

Channel Marker, Inc

  • Community/Behavioral Health Agency
  • Cambridge, MD
National Provider Identifier
1104004647
Registry record updated Dec 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
CHANNEL MARKER, INC
Practice address
420 Dorchester Ave
Cambridge, MD 21613-2446
Phone
(410) 228-8330
NPI assigned
Feb 7, 2008
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Catherine Cassell, LCSW-C
Title
Program Director
Phone
(410) 822-4619

National Provider Directory

National Provider Directory
Tax ID family
Channel Marker Inc9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

420 Dorchester Ave
Cambridge, MD 21613-2446

Mailing address

8865 Glebe Park Dr
Unit 1
Easton, MD 21601-7003
Phone (410) 822-4619

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
588251602MedicaidMD

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 20, 2016.

{
    "created_epoch": "1202342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482192000000",
    "number": "1104004647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8865 GLEBE PARK DR",
            "address_2": "UNIT 1",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "216017003",
            "telephone_number": "410-822-4619",
            "fax_number": "410-822-0984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 DORCHESTER AVE",
            "city": "CAMBRIDGE",
            "state": "MD",
            "postal_code": "216132446",
            "telephone_number": "410-228-8330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANNEL MARKER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-07",
        "last_updated": "2016-12-20",
        "status": "A",
        "authorized_official_last_name": "CASSELL",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "410-822-4619",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "588251602",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.