Healthcare Provider Details

I. General information

NPI: 1013522762
Provider Name (Legal Business Name): ANDREW MUSA FORDAY-WATSON LCSW-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: A. MUSA FORDAY LCSW-C

II. Dates (important events)

Enumeration Date: 09/10/2020
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 N ROSE ST # F1
BALTIMORE MD
21205-2555
US

IV. Provider business mailing address

1451 DARTMOUTH AVE
PARKVILLE MD
21234-5901
US

V. Phone/Fax

Practice location:
  • Phone: 443-800-6515
  • Fax:
Mailing address:
  • Phone: 443-977-3048
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number19748
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number19748
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: