Provider Demographics
NPI:1376919365
Name:POTOMAC CASE MANAGEMENT SERVICES, INC.
Entity Type:Organization
Organization Name:POTOMAC CASE MANAGEMENT SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:JOHNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-791-3087
Mailing Address - Street 1:22 S MARKET ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-5570
Mailing Address - Country:US
Mailing Address - Phone:301-791-3087
Mailing Address - Fax:
Practice Address - Street 1:1446 W PATRICK ST STE 16
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-3201
Practice Address - Country:US
Practice Address - Phone:301-791-3087
Practice Address - Fax:301-393-0730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-13
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD880111800Medicaid