Provider Demographics
NPI:1992364798
Name:DUCHARME, DESIREE (LCPC)
Entity Type:Individual
Prefix:
First Name:DESIREE
Middle Name:
Last Name:DUCHARME
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 ALDER DR APT B
Mailing Address - Street 2:
Mailing Address - City:MIDDLE RIVER
Mailing Address - State:MD
Mailing Address - Zip Code:21220-5011
Mailing Address - Country:US
Mailing Address - Phone:443-904-6370
Mailing Address - Fax:
Practice Address - Street 1:8 ALDER DR APT B
Practice Address - Street 2:
Practice Address - City:MIDDLE RIVER
Practice Address - State:MD
Practice Address - Zip Code:21220-5011
Practice Address - Country:US
Practice Address - Phone:443-904-6370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-06
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP8797101YM0800X
MDLC10603101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1027305Medicaid
MD249380200Medicaid