CORSICA RIVER MENTAL HEALTH SERVICES, INC. (NPI# 1396077749) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396077749 |
| Entity Type | Organization |
| Organization Name | CORSICA RIVER MENTAL HEALTH SERVICES, INC. |
| Practice Address |
120 Banjo Ln Centreville MD 21617-1002 |
| Mailing Address |
120 Banjo Ln P.o. Box 718 Centreville MD 21617-1002 |
| Practice Telephone | 4107582211 |
| Practice Fax Number | 4107581223 |
| Mailing Telephone | 4107582211 |
| Mailing Fax Number | 4107581223 |
| Enumeration Date | 2010-02-10 |
| Last Update Date | 2010-10-25 |
| Authorized Official Name | MR. JOHN F. PLASKON (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 4107583050 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities | ||
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 419867100 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093249583 | Corsica River Mental Health Services, Inc. | Clinic/Center | 516 Washington Ave Ste 4, Chestertown, MD 21620-1232 | 2017-04-12 |
| 1356875330 | Corsica River Mental Health Services, Inc. | Clinic/Center | 114 Market St Ste 207, Denton, MD 21629-1067 | 2017-04-17 |
| 1710411210 | Corsica River Mental Health Services, Inc. | Clinic/Center | 300 Talbot St, Easton, MD 21601-3525 | 2017-04-12 |
| 1386178879 | Corsica River Mental Health Services, Inc. | Clinic/Center | 502 Poplar St, Cambridge, MD 21613-1834 | 2017-04-12 |
| 1295269785 | Corsica River Mental Health Services, Inc. | Clinic/Center | 120 Banjo Ln, Centreville, MD 21617-1002 | 2017-04-12 |
| 1922532415 | Corsica River Mental Health Services, Inc. | Clinic/Center | 933 S Talbot St Ste 4, St Michaels, MD 21663-2605 | 2017-04-12 |
| 1184171902 | Corsica River Mental Health Services, Inc. | Clinic/Center | 300 Talbot St, Easton, MD 21601-3525 | 2016-09-09 |
| 1033663802 | Corsica River Mental Health Services, Inc. | Clinic/Center | 516 Washington Ave, Suite 4, Chestertown, MD 21620-1225 | 2016-08-10 |
| 1023562899 | Corsica River Mental Health Services, Inc. | Clinic/Center | 114 Market St, Suite 207, Denton, MD 21629-1065 | 2016-08-10 |
| 1306220322 | Corsica River Mental Health Services, Inc. | Clinic/Center | 502 Poplar St, Cambridge, MD 21613-1834 | 2015-07-20 |
| Street Address |
120 BANJO LN |
| City | CENTREVILLE |
| State | MD |
| Zip Code | 21617-1002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205822053 | Lesley Todd | Nurse Practitioner | 120 Banjo Ln, Centreville, MD 21617-1002 | 2005-09-26 |
| 1245877182 | Crossroads Community, Inc. | Community/Behavioral Health | 120 Banjo Ln, Centreville, MD 21617-1002 | 2019-12-10 |
| 1346883360 | Courtney Marie Miller | Social Worker | 120 Banjo Ln, Centreville, MD 21617-1002 | 2019-10-22 |
| 1154983138 | Corsica River Mental Health Services, Inc | Case Management | 120 Banjo Ln, Centreville, MD 21617-1002 | 2019-07-01 |
| 1033695028 | Ashley Hall | Counselor | 120 Banjo Ln, Centreville, MD 21617-1002 | 2018-07-13 |
| 1295269785 | Corsica River Mental Health Services, Inc. | Clinic/Center | 120 Banjo Ln, Centreville, MD 21617-1002 | 2017-04-12 |
| 1568912657 | Crossroads Community, Inc. | Community/Behavioral Health | 120 Banjo Ln, Centreville, MD 21617-1002 | 2016-10-12 |
| 1730636192 | Erin Elizabeth Cannon | Social Worker | 120 Banjo Ln, Centreville, MD 21617-1002 | 2016-09-02 |
| 1346608916 | Corsica River Mental Health Services, Inc | Clinic/Center | 120 Banjo Ln, Centreville, MD 21617-1002 | 2016-02-10 |
| 1437517000 | Crossroads Community, Inc. | Community/Behavioral Health | 120 Banjo Ln, Centreville, MD 21617-1002 | 2016-02-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518322445 | Marianna Edmonston | Occupational Therapy Assistant | 205 Armstrong St., Genesis Rehabilitation Services Corsica Hills, Centreville, MD 21617 | 2015-12-18 |
| 1881089084 | Michelle Katherine Priddy | Specialist/Technologist | 125 Ruthsburg Rd., Centreville, MD 21617 | 2015-04-03 |
| 1801220579 | Kimberly Patrice Wilson | Counselor | 205 North Liberty St, Centreville, MD 21617 | 2013-08-29 |
| 1588940787 | Angela Renee Sommer | Speech-Language Pathologist | 205 Armstrong Street, Genesis Rehabilitation Services Corsica Hills, Centreville, MD 21617 | 2011-11-01 |
| 1497067144 | Alison Lynn Mccuen | Speech-Language Pathologist | 175 Ashland Drive, Centreville, MD 21617 | 2010-07-10 |
| 1427269406 | Hospice of Queen Anne's Inc. | Hospice Care, Community Based | 255 Comet Drive, Centreville, MD 21617 | 2007-05-24 |
| 1093921470 | Lillian Sheehan | Social Worker | 152 Courseval Drive, Ste 142, Centreville, MD 21617 | 2007-05-15 |
| 1184723942 | Centreville Drugs Inc | Durable Medical Equipment & Medical Supplies | 102 Commerce Street, Centreville, MD 21617 | 2006-09-21 |
| 1114022670 | James J Lucas | Dentist | 134 Coursevall Drive, Centerville, MD 21617 | 2006-09-13 |
| 1730129370 | Joseph C Titus | Social Worker | 120 Banjo Lane, Centreville, MD 21617 | 2006-06-08 |
| Find all providers in zip 21617 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
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|---|---|---|---|---|
| 1811305733 | Catherine Elizabeth Sims, LLC | Clinic/Center | 6705 Bay Valley Lane, Centreville, VA 20121 | 2014-07-23 |
| 1346608916 | Corsica River Mental Health Services, Inc | Clinic/Center | 120 Banjo Ln, Centreville, MD 21617-1002 | 2016-02-10 |
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| 1811519564 | Womens Healing Center LLC | Clinic/Center | 8167 Main St Ste 206, Ellicott City, MD 21043-4776 | 2020-05-15 |
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| 1295355352 | Bright Care Solutions LLC | Clinic/Center | 8702 Castlerock Ct, Laurel, MD 20723-2702 | 2020-04-19 |
| Find all providers with the same taxonomy | ||||
| City | CENTREVILLE |
| Zip Code | 21617 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.