Provider Demographics
NPI:1093467904
Name:CITY OF FREDERICK
Entity Type:Organization
Organization Name:CITY OF FREDERICK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR OF BEHAVIORAL HEALTH
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLDEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:301-305-8540
Mailing Address - Street 1:100 S MARKET ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-5527
Mailing Address - Country:US
Mailing Address - Phone:301-600-1393
Mailing Address - Fax:
Practice Address - Street 1:100 S MARKET ST
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-5527
Practice Address - Country:US
Practice Address - Phone:301-600-1393
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CITY OF FREDERICK
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-01-21
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty