Provider Demographics
NPI:1780742031
Name:VLASITS, TONI ANTOINETTE (LCSW C)
Entity type:Individual
Prefix:MS
First Name:TONI
Middle Name:ANTOINETTE
Last Name:VLASITS
Suffix:
Gender:F
Credentials:LCSW C
Other - Prefix:
Other - First Name:ADHIKARI
Other - Middle Name:
Other - Last Name:VLASITS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW C
Mailing Address - Street 1:6203 C PIMLICO RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209
Mailing Address - Country:US
Mailing Address - Phone:410-764-3494
Mailing Address - Fax:
Practice Address - Street 1:6203 C PIMLICO RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209
Practice Address - Country:US
Practice Address - Phone:410-764-3494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD08270104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDQB79TVOtherBCBS
MD4050100Medicaid
MD4292OtherBCBS
MD4292OtherBCBS