Provider Demographics
NPI:1033738422
Name:MASO, KATHARINE G (LMSW)
Entity Type:Individual
Prefix:
First Name:KATHARINE
Middle Name:G
Last Name:MASO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 RAKOV RD
Mailing Address - Street 2:
Mailing Address - City:MAYBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:12543-1145
Mailing Address - Country:US
Mailing Address - Phone:845-467-7954
Mailing Address - Fax:
Practice Address - Street 1:67 WINDSOR HWY
Practice Address - Street 2:
Practice Address - City:NEW WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:12553-6200
Practice Address - Country:US
Practice Address - Phone:845-421-0177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-15
Last Update Date:2020-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY106361104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker