Provider Demographics
NPI:1043859770
Name:MASSEY, ADANA (LCPC)
Entity Type:Individual
Prefix:
First Name:ADANA
Middle Name:
Last Name:MASSEY
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:ADANA
Other - Middle Name:ROYAL
Other - Last Name:MASSEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:711 RESERVOIR ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21217-4616
Mailing Address - Country:US
Mailing Address - Phone:410-728-3350
Mailing Address - Fax:
Practice Address - Street 1:1701 MADISON AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21217-3731
Practice Address - Country:US
Practice Address - Phone:410-728-1800
Practice Address - Fax:410-728-1808
Is Sole Proprietor?:No
Enumeration Date:2019-12-28
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC11711101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health