NPIMap

Andrea Cheezum, ALCOHOL/DRUG TRAINEE

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Centreville, MD

NPI 1518129147 · NPPES record last updated Jun 25, 2008

Key facts

NPI
1518129147
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
ALCOHOL/DRUG TRAINEE (MD)
Practice address
205 N Liberty St
Centreville, MD 21617-1022
Phone
(410) 758-1306
Fax
(410) 758-2133
NPI assigned
Jun 25, 2008
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
ALCOHOL/DRUG TRAINEEMDMDAddiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X ALCOHOL/DRUG TRAINEE MD Yes

Addresses

Primary practice location

205 N Liberty St
Centreville, MD 21617-1022

Mailing address

206 N Commerce St
Centreville, MD 21617-1049
Phone (410) 758-1306

Other providers in Centreville, MD

All providers in Centreville, MD · Addiction (Substance Use Disorder) Counselor in Maryland

Sources for this page

Verify at the official NPI Registry.