Provider Demographics
NPI:1922340728
Name:AHMANSON, DORIA (MSW, LCSW-C)
Entity Type:Individual
Prefix:MRS
First Name:DORIA
Middle Name:
Last Name:AHMANSON
Suffix:
Gender:F
Credentials:MSW, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8850 COLUMBIA 100 PKWY STE 203
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-2376
Mailing Address - Country:US
Mailing Address - Phone:443-546-4476
Mailing Address - Fax:443-546-4473
Practice Address - Street 1:8850 COLUMBIA 100 PKWY STE 203
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045
Practice Address - Country:US
Practice Address - Phone:443-546-4476
Practice Address - Fax:443-546-4473
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-20
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15045101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health