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CHESTER RIVER BEHAVIORAL HEALTH LLC NPI 1487676524


NPI Information

NPI: 1487676524
Provider Name: CHESTER RIVER BEHAVIORAL HEALTH, LLC
Classification: Psychologist - 103TC0700X
Entity Type: Organization

Specialization: Clinical

CLIA Number: 21D0220360

Address:
952 WASHINGTON AVE
SUITE 500
CHESTERTOWN, MD
ZIP 21620
Phone: (410) 778-5550
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CHESTER RIVER BEHAVIORAL HEALTH, LLC is a clinical psychologist in Chestertown, MD. The provider is 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. CHESTER RIVER BEHAVIORAL HEALTH, LLC NPI is 1487676524. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

952 WASHINGTON AVE
SUITE 500
CHESTERTOWN, MD
ZIP 21620-322
Phone: (410) 778-5550
Fax: (410) 778-0984

The provider's authorized official is Teresa Ingram Schaefer .
The authorized official title is Member/partner and has the following contact phone number (410) 778-5550.

The CLIA number assigned to this NPI record is 21D0220360 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/25/2006 and was last updated on 3/16/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YP2500XCounselorProfessionalLC4278MARYLANDNo
2101YP2500XCounselorProfessionalLC6557MARYLANDNo
3101YP2500XCounselorProfessionalLC0691MARYLANDNo
4103T00000XPsychologist01371MARYLANDNo
5103T00000XPsychologist05728MARYLANDNo
6103TC2200XPsychologistClinical Child & Adolescent03590MARYLANDNo
71041C0700XSocial WorkerClinical02571MARYLANDNo
81041C0700XSocial WorkerClinical04572MARYLANDNo
91041C0700XSocial WorkerClinical19033MARYLANDNo
10103TC0700XPsychologistClinical02027MARYLANDYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1T418OTHERMARYLANDBLUE CROSS NAT GROUP #
2077MMEDICARE ID-TYPE UNSPECIFIEDMARYLANDGROUP ID NUMBER
3LT86CHOTHERMARYLANDBLUE CROSS LOCAL GROUP #

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.