Provider Demographics
NPI:1679024616
Name:CHANNEL MARKER, INC
Entity Type:Organization
Organization Name:CHANNEL MARKER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CASSELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:410-822-4619
Mailing Address - Street 1:8865 GLEBE PARK DR
Mailing Address - Street 2:UNIT 1
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-7003
Mailing Address - Country:US
Mailing Address - Phone:410-822-4619
Mailing Address - Fax:
Practice Address - Street 1:508 KERR AVE
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:MD
Practice Address - Zip Code:21629-1343
Practice Address - Country:US
Practice Address - Phone:410-479-2318
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-14
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health