Provider Demographics
NPI:1962535716
Name:CHARLES COUNTY HEALTH DEPARTMENT
Entity type:Organization
Organization Name:CHARLES COUNTY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:DIANNA
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:ABNEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-609-6902
Mailing Address - Street 1:4545 CRAIN HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:MD
Mailing Address - Zip Code:20695-0000
Mailing Address - Country:US
Mailing Address - Phone:301-609-6927
Mailing Address - Fax:301-609-6939
Practice Address - Street 1:4545 CRAIN HIGHWAY
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:MD
Practice Address - Zip Code:20695-0000
Practice Address - Country:US
Practice Address - Phone:301-609-6927
Practice Address - Fax:301-609-6939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD754240200Medicaid