| Potomac Community Services | |
|
324 E Antietam St Ste 104 Hagerstown MD 21740-5754 | |
| (301) 791-3087 | |
| Not Available |
| Full Name | Potomac Community Services |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 324 E Antietam St Ste 104, Hagerstown, Maryland |
| Authorized Official Name and Position | Dawn Renee Johns (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3017913087 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Potomac Community Services 324 E Antietam St Suite 301 Hagerstown MD 21740-5754 Ph: (301) 791-3087 | Potomac Community Services 324 E Antietam St Ste 104 Hagerstown MD 21740-5754 Ph: (301) 791-3087 |
| NPI Number | 1174999650 |
|---|---|
| Provider Enumeration Date | 08/19/2015 |
| Last Update Date | 06/07/2023 |
| Certification Date | 06/07/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174999650 | NPI | - | NPPES |
| 880111800 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
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