Provider Demographics
NPI:1669202867
Name:WHITNEY MASCARO LLC
Entity type:Organization
Organization Name:WHITNEY MASCARO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WHITNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MASCARO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:804-386-8217
Mailing Address - Street 1:1106 APPERSON ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23231-3309
Mailing Address - Country:US
Mailing Address - Phone:804-386-8217
Mailing Address - Fax:
Practice Address - Street 1:1106 APPERSON ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23231-3309
Practice Address - Country:US
Practice Address - Phone:804-386-8217
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-03
Last Update Date:2024-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty