Mental Health Association of Frederick County

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

MENTAL HEALTH ASSOCIATION OF FREDERICK COUNTY

Practice address

226 S Jefferson St
Frederick, MD 21701-6205

Phone

(301) 663-0011

NPI assigned

Oct 2, 2020

Organization subpart

No

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

Authorized official

Name

Eva Marie Costlow, LCSW-CNPI 1811594849

Title

Clinical Supervisor

Phone

(301) 663-6135

Specialties & licenses 1

Addresses

Practitioners 1

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

• Eva Marie Costlow, LCSW-C

  • Clinical Social Worker
  • Frederick, MD
  • NPI 1811594849
  NPD Authorized official

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

{
    "created_epoch": "1601596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601596800000",
    "number": "1659978732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 S JEFFERSON ST",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217016205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 S JEFFERSON ST",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217016205",
            "telephone_number": "301-663-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTAL HEALTH ASSOCIATION OF FREDERICK COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-02",
        "last_updated": "2020-10-02",
        "certification_date": "2020-09-28",
        "status": "A",
        "authorized_official_last_name": "COSTLOW",
        "authorized_official_first_name": "EVA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "CLINICAL SUPERVISOR",
        "authorized_official_telephone_number": "301-663-6135",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mental Health Assoc of Frederick Cty
• Mental Health Assoc of Frederick Cty
• Mental Health Assoc of Frederick Cty
• Mental Health Assoc of Frederick Cty, Mobile Crisis Services
• Mental Health Assoc. of Frederick Country, Counseling Services
• Mental Shift Wellness
• Mentor-Maryland
• Antonia Mentzer
• April John Tambaoan Mercado, NP
• Courteny Christine Mercer

• Mental Health Clinic/Center (Including Community Mental Health Center) in Frederick, MD
• Providers in Frederick, MD by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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.