Provider Demographics
NPI:1760039333
Name:CHESAPEAKE PSYCHOLOGY, INC
Entity Type:Organization
Organization Name:CHESAPEAKE PSYCHOLOGY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GEETA
Authorized Official - Middle Name:
Authorized Official - Last Name:SARPHARE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:240-650-0779
Mailing Address - Street 1:3905 NATIONAL DR STE 230
Mailing Address - Street 2:
Mailing Address - City:BURTONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20866-6101
Mailing Address - Country:US
Mailing Address - Phone:240-650-0779
Mailing Address - Fax:443-583-3872
Practice Address - Street 1:3905 NATIONAL DR STE 230
Practice Address - Street 2:
Practice Address - City:BURTONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20866-6101
Practice Address - Country:US
Practice Address - Phone:240-650-0779
Practice Address - Fax:443-583-3872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-19
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty