Healthcare Provider Details

I. General information

NPI: 1285587212
Provider Name (Legal Business Name): AISHA JAMIL MASON LGPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/18/2026
Last Update Date: 02/18/2026
Certification Date: 02/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10220 S DOLFIELD RD STE 209
OWINGS MILLS MD
21117-3624
US

IV. Provider business mailing address

8 CORAL BELL CT
OWINGS MILLS MD
21117-5040
US

V. Phone/Fax

Practice location:
  • Phone: 410-773-9607
  • Fax: 410-697-5501
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLGP16885
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: