Provider Demographics
NPI:1821468182
Name:MASTEN, ASHLEY M (LCSW-C)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:M
Last Name:MASTEN
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6501 N CHARLES ST
Mailing Address - Street 2:ROOM D225
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21204-6819
Mailing Address - Country:US
Mailing Address - Phone:410-938-3464
Mailing Address - Fax:410-938-5131
Practice Address - Street 1:6535 N CHARLES ST
Practice Address - Street 2:PAVILION NORTH, SUITE 100
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21204-5826
Practice Address - Country:US
Practice Address - Phone:443-849-2707
Practice Address - Fax:443-849-8066
Is Sole Proprietor?:No
Enumeration Date:2015-09-30
Last Update Date:2016-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD173331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical