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21D0220360 CLIA NUMBER - CHESTER RIVER PHYSICIANS

Laboratory Demographics

CLIA Number: 21D0220360

Facility Name: CHESTER RIVER PHYSICIANS

Facility Address:
415 WASHINGTON AVE SUITE 2
CHESTERTOWN, MD
ZIP 21620
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Facility Phone Number: 410 778-6410

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1487676524

Taxonomy: 103TC0700X - Psychologist
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

CLIA Record

Field Name Field Value
CLIA Number 21D0220360
LAB Type Physician Office
Facility Name CHESTER RIVER PHYSICIANS
Street 415 WASHINGTON AVE SUITE 2
City CHESTERTOWN
State MD
ZIP 21620
Phone 410 778-6410
CertificateType 4
CertificateEffectiveDate 9/1/2022
CertificateExpirationDate 8/31/2024
FacilityType Waiver

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This page was last updated on: 4/23/2024