Provider Demographics
NPI:1053101279
Name:MASLAN, COLIN DANIEL (LCSW)
Entity type:Individual
Prefix:
First Name:COLIN
Middle Name:DANIEL
Last Name:MASLAN
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1330 LINCOLN AVE STE 308C
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94901-2141
Mailing Address - Country:US
Mailing Address - Phone:628-313-6211
Mailing Address - Fax:
Practice Address - Street 1:1330 LINCOLN AVE STE 308C
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-2141
Practice Address - Country:US
Practice Address - Phone:628-313-6211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-09
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1297311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical