1831151844 NPI number — DOUGLAS MARSHALL CHAY MSW LCSW C

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831151844 NPI number — DOUGLAS MARSHALL CHAY MSW LCSW C

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

CHAY

Provider First Name:

DOUGLAS

Provider Middle Name:

MARSHALL

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

MSW LCSW C

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1831151844

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

04/09/2008

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

1406 B CRAIN HWY S

Provider Second Line Business Mailing Address:

SUITE 301

Provider Business Mailing Address City Name:

GLEN BURNIE

Provider Business Mailing Address State Name:

MD

Provider Business Mailing Address Postal Code:

21061

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

410-760-5588

Provider Business Mailing Address Fax Number:

410-760-9727

Provider First Line Business Practice Location Address:

1406B CRAIN HWY S

Provider Second Line Business Practice Location Address:

SUITE 301

Provider Business Practice Location Address City Name:

GLEN BURNIE

Provider Business Practice Location Address State Name:

MD

Provider Business Practice Location Address Postal Code:

21061-4099

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

410-760-5588

Provider Business Practice Location Address Fax Number:

410-760-9727

Provider Enumeration Date:

04/05/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 1041C0700X , with the licence number:  09267 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 0008 . This is a "BLUE SHIELD FEDERAL" identifier . This identifiers is of the category "OTHER".
• Identifier: 10761882 . This is a "CAQH" identifier . This identifiers is of the category "OTHER".
• Identifier: 245079 . This is a "MHN AND TRICARE" identifier . This identifiers is of the category "OTHER".
• Identifier: 264800000 . This is a "MAGELLAN BEHAVIORAL HEALT" identifier . This identifiers is of the category "OTHER".
• Identifier: 287864 . This is a "MAMSI UNITED HEALTH CARE" identifier . This identifiers is of the category "OTHER".
• Identifier: S003 . This is a "BLUE SHIELD FEDERAL GROUP" identifier . This identifiers is of the category "OTHER".
• Identifier: 162110 . This is a "VALUE OPTIONS AND GREAT W" identifier . This identifiers is of the category "OTHER".
• Identifier: 513264 . This is a "NCPPO INNOVA MHIP" identifier . This identifiers is of the category "OTHER".
• Identifier: 522229157 . This is a "PHCS" identifier . This identifiers is of the category "OTHER".
• Identifier: 7626281 . This is a "AETNA BEHAVIORAL HEALTH" identifier . This identifiers is of the category "OTHER".
• Identifier: 100033664 . This is a "APS" identifier . This identifiers is of the category "OTHER".
• Identifier: 61002201 . This is a "BLUE SHIELD OF MD" identifier . This identifiers is of the category "OTHER".