Basic Information
| Provider Information | |||||||||
| NPI: | 1821468182 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MASTEN | ||||||||
| FirstName: | ASHLEY | ||||||||
| MiddleName: | M. | ||||||||
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| Credential: | LCSW-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6501 N CHARLES ST | ||||||||
| Address2: | ROOM D225 | ||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212046819 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4109383464 | ||||||||
| FaxNumber: | 4109385131 | ||||||||
| Practice Location | |||||||||
| Address1: | 6535 N CHARLES ST | ||||||||
| Address2: | PAVILION NORTH, SUITE 100 | ||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212045826 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4438492707 | ||||||||
| FaxNumber: | 4438498066 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/30/2015 | ||||||||
| LastUpdateDate: | 11/11/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 17333 | MD | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.