MEDICARE: MISS ANGELINA MASCARDO MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	6801061445	OTHER	MI	MSW

General Provider Information

NPI Number	:	1841402823
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS ANGELINA MASCARDO MSW

Provider Business Mailing Address
First Line	:	6309 MACK
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48207
Country	:	US
Telephone Number	:	313-921-4700
Fax Number	:	313-921-4125

Provider Business Practice Location Address
First Line	:	6309 MACK
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48207
Country	:	US
Telephone Number	:	313-921-4700
Fax Number	:	313-921-4125

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2007
Last Update Date	:	04/12/2026

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