Provider Demographics
NPI:1013574805
Name:NSUDE, CHRITY
Entity Type:Individual
Prefix:
First Name:CHRITY
Middle Name:
Last Name:NSUDE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14300 CHERRY LANE CT STE 202-203
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-4958
Mailing Address - Country:US
Mailing Address - Phone:240-360-2637
Mailing Address - Fax:
Practice Address - Street 1:14300 CHERRY LANE CT STE 202-203
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-4958
Practice Address - Country:US
Practice Address - Phone:240-360-2637
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-28
Last Update Date:2019-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD660023900Medicaid