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General NPI Number Information
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NPI Number | 1972893733
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Entity Type | Organization
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Legal Business Name | AVA BARRON-SHASHO, LCSW-C, LLC
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Dates
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Enumeration Date | 04/13/2011
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Last Update Date | 05/05/2011
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Provider Practice Location Address
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Address Line | 10806 REISTERSTOWN RD SUITE 1B
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City | OWINGS MILLS
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State | MD
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Zip | 21117-2700
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Country | US
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Telephone | 410-356-0796
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Fax |
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Provider Business Mailing Address
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Address Line | 10806 REISTERSTOWN RD SUITE 1B
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City | OWINGS MILLS
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State | MD
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Zip | 21117-2700
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Country | US
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Telephone | 410-356-0796
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AVA IRIS BARRON-SHASHO
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Credential | LCSW-C
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Telephone | 410-356-0796
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 08655
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License Number State | MD
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