# COURAGE TO CHANGE OF SOUTHERN MARYLAND

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609924877
- **Authorized official:** MS. MARJORIE HUMKE M.A., L.C.A.D.C. (PROGRAM DIRECTOR)
- **Authorized official phone:** (410) 414-9050

## Contact information

- **Practice address:** 96 ARMORY RD, SUITE 102, PRINCE FREDERICK, MD 20678-4117
- **Practice address phone:** (410) 414-9050
- **Practice address fax:** (410) 414-9060
- **Mailing address:** 96 ARMORY RD, SUITE 102, PRINCE FREDERICK, MD 20678-4117
- **Mailing address phone:** (410) 414-9050
- **Mailing address fax:** (410) 414-9060

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | LCA091 | MD | Yes |

## Other

- **Enumeration date:** 01/06/2007
- **Last updated:** 08/22/2020