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Organization

CHESAPEAKE BEHAVIORAL HEALTH CENTER, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. LUCY J. CORREA-CASHDOLLAR R.N. (PRACTICE MANAGER)
(410) 833-0581
Entity
Organization

Contact information

Practice address
217 MAIN ST, SUITE B, REISTERSTOWN, MD 21136-1213
(410) 833-0581
(410) 833-8604
Mailing address
217 MAIN ST, SUITE B, REISTERSTOWN, MD 21136-1213
(410) 833-0581
(410) 833-8604

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
D0020136
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0007543711
AETNA
MD
01
225P
MEDICARE GROUP NUMBER
MD
01
284CCH
CAREFIRST OF MARYLAND
MD
05
4168160 00
MD
01
K876
GHMSI & BLUE CHOICE, INC
MD
Enumeration date
03/23/2006
Last updated
08/26/2016
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