Provider Demographics
NPI:1598162778
Name:HOWARD COUNTY HEALTH DEPARTMENT BUREAU OF BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:HOWARD COUNTY HEALTH DEPARTMENT BUREAU OF BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FISCAL MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CARLETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-313-6300
Mailing Address - Street 1:8930 STANFORD BLVD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-5805
Mailing Address - Country:US
Mailing Address - Phone:410-313-6300
Mailing Address - Fax:410-313-4250
Practice Address - Street 1:8930 STANFORD BLVD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-5805
Practice Address - Country:US
Practice Address - Phone:410-313-6300
Practice Address - Fax:410-313-4250
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOWARD COUNTY HEALTH DEPARTMENT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-12-03
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD423206200Medicaid
MD420885400Medicaid