Provider Demographics
NPI:1750011680
Name:SPADIN, AUBREY LEIGH (LMSW)
Entity Type:Individual
Prefix:
First Name:AUBREY
Middle Name:LEIGH
Last Name:SPADIN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:AUBREY
Other - Middle Name:
Other - Last Name:FERRUCCIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:902 PARKER RD APT 2
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-9038
Mailing Address - Country:US
Mailing Address - Phone:443-736-6644
Mailing Address - Fax:
Practice Address - Street 1:23704 OCEAN GTWY
Practice Address - Street 2:
Practice Address - City:MARDELA SPRINGS
Practice Address - State:MD
Practice Address - Zip Code:21837-2101
Practice Address - Country:US
Practice Address - Phone:410-742-7400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-14
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD28709104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD160008700Medicaid