Calvert County Health Department
Organization Active NPI Adolescent and Children Mental Health Clinic/Center · Lusby, MD
NPI 1831546845 · NPPES record last updated Nov 16, 2022
Key facts
- NPI
- 1831546845
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Adolescent and Children Mental Health Clinic/Center 261QM0855X
- Legal business name
- CALVERT COUNTY HEALTH DEPARTMENT
- Practice address
- 11845 HG Trueman Rd
Lusby, MD 20657-2855 - Phone
- (410) 394-0681
- NPI assigned
- May 19, 2016
- Organization subpart
- No
Authorized official
- Name
- Doris J McDonald
- Title
- Director of Behavioral Health
- Phone
- (410) 535-3079
Other NPIs on the same Medicare enrollment 7
Practitioners 3
-
Travis Wayne Roberts, NP-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20121119000361 | MD | Part B Supplier - Clinic/Group Practice | 7214188366 |
Receives reassigned benefits from 23 practitioners 7 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Lusby, MD; Prince Frederick, MD; North Beach, MD; Chesapeake Beach, MD |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Mental Health Clinic/Center | 261QM0850X | MD | ||
| Adolescent and Children Mental Health Clinic/Center | 261QM0855X | MD | Yes |
Addresses
Primary practice location
11845 HG Trueman Rd
Lusby, MD 20657-2855
Mailing address
PO Box 980
Prince Frederick, MD 20678-0980
Other names
- Calvert County Mental Health Clinic
Other providers in Lusby, MD
- Alexis Morgan Broom
- Dennis McCray Bullock
- Calvert County Health Department
- Calvert County Health Department
- Calvert County Health Department
- Calvert Memorial Hospital of Calvert County
- Joan Carey
- Charles W Bennett MD LLC
- Amanda Diane Cipriani
- Shannon Crush
All providers in Lusby, MD · Adolescent and Children Mental Health Clinic/Center in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 16, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.