Provider Demographics
NPI:1033574678
Name:PROJECT CHESAPEAKE LLC
Entity Type:Organization
Organization Name:PROJECT CHESAPEAKE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:REBEKHA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:443-214-5097
Mailing Address - Street 1:185 ADMIRAL COCHRANE DR STE 120
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7600
Mailing Address - Country:US
Mailing Address - Phone:443-440-5782
Mailing Address - Fax:443-378-8538
Practice Address - Street 1:108 OLD SOLOMONS ISLAND RD
Practice Address - Street 2:BUILDING 2 SUITE 1
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3845
Practice Address - Country:US
Practice Address - Phone:443-214-5097
Practice Address - Fax:443-378-8538
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-28
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD423286100Medicaid
MD423286100Medicaid