NPIMap

Organization Active NPI

Chesapeake Church

Doing business as Chesapeake Christian Counseling Center

  • Clinical Social Worker
  • Huntingtown, MD
National Provider Identifier
1396747358
Registry record updated Mar 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
CHESAPEAKE CHURCH
Doing business as
Chesapeake Christian Counseling Center
Practice address
6045 Solomons Island Rd
Huntingtown, MD 20639-8876
Phone
(410) 257-5200
Fax
(410) 257-2442
NPI assigned
Jun 2, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Robin Brungard, LCSW-CNPI 1962403337
Title
Managing Director
Phone
(410) 257-5200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

6045 Solomons Island Rd
Huntingtown, MD 20639-8876

Mailing address

6045 Solomons Island Rd
Huntingtown, MD 20639-8876
Phone (410) 257-5200

Other identifiers 2

IdentifierTypeStateIssuer
LP57OtherMDCAREFIRST BC/BS
F453OtherMDCAREFIRST BLUECHOICE

Other names 1

  • Chesapeake Christian Counseling Center Doing business as

National Provider Directory

National Provider Directory

Locations

6045 Solomons Island Rd
Huntingtown, MD 20639
Phone (410) 257-5200

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1117670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204675200000",
    "number": "1396747358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6045 SOLOMONS ISLAND RD",
            "city": "HUNTINGTOWN",
            "state": "MD",
            "postal_code": "206398876",
            "telephone_number": "410-257-5200",
            "fax_number": "410-257-2442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6045 SOLOMONS ISLAND RD",
            "city": "HUNTINGTOWN",
            "state": "MD",
            "postal_code": "206398876",
            "telephone_number": "410-257-5200",
            "fax_number": "410-257-2442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHESAPEAKE CHURCH",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-02",
        "last_updated": "2008-03-05",
        "status": "A",
        "authorized_official_last_name": "BRUNGARD",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "410-257-5200",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BC/BS",
            "identifier": "LP57",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BLUECHOICE",
            "identifier": "F453",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chesapeake Christian Counseling Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Huntingtown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2008; 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.