Provider Demographics
NPI:1649549411
Name:C.A. MAYO AND ASSOCIATES, INC.
Entity type:Organization
Organization Name:C.A. MAYO AND ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:C.
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:MAYO
Authorized Official - Suffix:
Authorized Official - Credentials:DSW
Authorized Official - Phone:301-699-0344
Mailing Address - Street 1:3403 PERRY ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT RAINIER
Mailing Address - State:MD
Mailing Address - Zip Code:20712-2139
Mailing Address - Country:US
Mailing Address - Phone:301-699-0344
Mailing Address - Fax:301-699-0343
Practice Address - Street 1:3403 PERRY ST
Practice Address - Street 2:
Practice Address - City:MOUNT RAINIER
Practice Address - State:MD
Practice Address - Zip Code:20712-2139
Practice Address - Country:US
Practice Address - Phone:301-699-0344
Practice Address - Fax:301-699-0343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-22
Last Update Date:2011-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD001685251S00000X, 251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health