Healthcare Provider Details

I. General information

NPI: 1407621865
Provider Name (Legal Business Name): BERLINE FLORENCE MAHOUND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2023
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17112 PAPS LN APT 1
HAGERSTOWN MD
21740-2362
US

IV. Provider business mailing address

17112 PAPS LN APT 1
HAGERSTOWN MD
21740-2362
US

V. Phone/Fax

Practice location:
  • Phone: 240-707-7100
  • Fax:
Mailing address:
  • Phone: 240-707-7100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number27450
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: