Organization
COURAGE TO CHANGE OF SOUTHERN MARYLAND
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARJORIE HUMKE M.A., L.C.A.D.C. (PROGRAM DIRECTOR)
(410) 414-9050
Entity
Organization
Contact information
Practice address
96 ARMORY RD, SUITE 102, PRINCE FREDERICK, MD 20678-4117
(410) 414-9050
(410) 414-9060
Mailing address
96 ARMORY RD, SUITE 102, PRINCE FREDERICK, MD 20678-4117
(410) 414-9050
(410) 414-9060
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCA091
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD-10343401
SAMIS ID
MD
Enumeration date
01/06/2007
Last updated
08/22/2020
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