Provider Demographics
NPI:1417087123
Name:CHARLETTA E. GALLATIN
Entity Type:Organization
Organization Name:CHARLETTA E. GALLATIN
Other - Org Name:HARFORD COUNTY HEALTH DEPT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROGRAM SUPERVISOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CHARLETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:GALLATIN
Authorized Official - Suffix:
Authorized Official - Credentials:CAC-AD
Authorized Official - Phone:410-638-3080
Mailing Address - Street 1:119 S HAYS ST
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-3644
Mailing Address - Country:US
Mailing Address - Phone:410-638-3080
Mailing Address - Fax:410-879-6823
Practice Address - Street 1:119 S HAYS ST
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-3644
Practice Address - Country:US
Practice Address - Phone:410-638-3080
Practice Address - Fax:410-879-6823
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC0182101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty