Provider Demographics
NPI:1912566878
Name:WOODFORD, JASON ARTURO SR (LMSW)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:ARTURO
Last Name:WOODFORD
Suffix:SR
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3922 BONNER RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21216-1203
Mailing Address - Country:US
Mailing Address - Phone:443-801-4062
Mailing Address - Fax:
Practice Address - Street 1:4000 OLD COURT RD STE 206
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-6415
Practice Address - Country:US
Practice Address - Phone:443-651-4019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-13
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD23956104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker