Courage to Change of Southern Maryland

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LCA091 Issued in MD

Legal business name

COURAGE TO CHANGE OF SOUTHERN MARYLAND

Practice address

96 Armory Rd
Suite 102
Prince Frederick, MD 20678-4117

Phone

(410) 414-9050

Fax

(410) 414-9060

NPI assigned

Jan 6, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Marjorie Humke, M.A., L.C.A.D.C.

Title

Program Director

Phone

(410) 414-9050

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1168041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609924877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 ARMORY RD",
            "address_2": "SUITE 102",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206784117",
            "telephone_number": "410-414-9050",
            "fax_number": "410-414-9060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 ARMORY RD",
            "address_2": "SUITE 102",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206784117",
            "telephone_number": "410-414-9050",
            "fax_number": "410-414-9060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COURAGE TO CHANGE OF SOUTHERN MARYLAND",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HUMKE",
        "authorized_official_first_name": "MARJORIE",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "410-414-9050",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.A., L.C.A.D.C."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MD",
            "license": "LCA091",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SAMIS ID",
            "identifier": "MD-10343401",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cornerstone Montgomery, Inc.
• Cornerstone Montgomery, Inc.
• Cornerstone Montgomery, Inc.
• Lillian Cornett
• Marijo Cosmas, MS, RN, AOCN, CRNP
• Chelsi Lee Cox, MSN, APRN, FNP-C
• Juliana Cox, LCSW
• Shannon Elizabeth Cox, MSN, APRN, FNP-C
• Patrick E Crarey, M.D.
• CRH MD Management LLC

• All providers in Prince Frederick, MD
• Addiction (Substance Use Disorder) Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.