NPIMap

Organization Active NPI

Calvert County Health Department

Doing business as Calvert County Mental Health Clinic

  • Adult Mental Health Clinic/Center
  • Prince Frederick, MD
National Provider Identifier
1609137918
Registry record updated Aug 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
License
14170 Issued in MD
Legal business name
CALVERT COUNTY HEALTH DEPARTMENT
Doing business as
Calvert County Mental Health Clinic
Practice address
975 Solomons Island Rd N
Suite 119
Prince Frederick, MD 20678-3917
Phone
(410) 535-5400
Fax
(410) 414-9413
NPI assigned
Jun 4, 2012
Last updated
Aug 9, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2016

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

Authorized official

Name
Mrs. Doris McDonald, MA, LCADC, LCPCNPI 1245421601
Title
Director
Phone
(410) 535-3079

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
Adult Mental Health Clinic/Center 261QM0850X 14170 MD Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X 14170 MD

Addresses

Primary practice location

975 Solomons Island Rd N
Suite 119
Prince Frederick, MD 20678-3917

Mailing address

PO Box 980
Prince Frederick, MD 20678-0980
Phone (410) 535-5400

Other identifiers 2

IdentifierTypeStateIssuer
420968100MedicaidMD
067984OtherMDBEACON HEALTH OPTIONS

Other names 1

  • Calvert County Mental Health Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121119000361 MD Part B Supplier - Clinic/Group Practice 7214188366 Receives reassigned benefits from 23 practitioners
7 other NPIs on this enrollment
Practice locations: Lusby, MD; Prince Frederick, MD; North Beach, MD; Chesapeake Beach, MD

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Calvert Cty HLTH Dept21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

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

View all 20

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1338768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470700800000",
    "number": "1609137918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 980",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206780980",
            "telephone_number": "410-535-5400",
            "fax_number": "410-414-9413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 SOLOMONS ISLAND RD N",
            "address_2": "SUITE 119",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206783917",
            "telephone_number": "410-535-5400",
            "fax_number": "410-414-9413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALVERT COUNTY HEALTH DEPARTMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-04",
        "last_updated": "2016-08-09",
        "status": "A",
        "authorized_official_last_name": "MCDONALD",
        "authorized_official_first_name": "DORIS",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "410-535-3079",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MA, LCADC, LCPC"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "MD",
            "license": "14170",
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "MD",
            "license": "14170",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "420968100",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEACON HEALTH OPTIONS",
            "identifier": "067984",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Calvert County Mental Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Prince Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.