Provider Demographics
NPI:1215099395
Name:MAPA, MA. ANNA TERESA (MS, LCPC, CSC-AD)
Entity type:Individual
Prefix:
First Name:MA. ANNA
Middle Name:TERESA
Last Name:MAPA
Suffix:
Gender:F
Credentials:MS, LCPC, CSC-AD
Other - Prefix:
Other - First Name:MANETTE
Other - Middle Name:
Other - Last Name:MAPA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, LCPC, CSC-AD
Mailing Address - Street 1:800 INGLESIDE AVE
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-1722
Mailing Address - Country:US
Mailing Address - Phone:410-744-4661
Mailing Address - Fax:410-744-9423
Practice Address - Street 1:3902 ANNAPOLIS RD
Practice Address - Street 2:
Practice Address - City:LANSDOWNE
Practice Address - State:MD
Practice Address - Zip Code:21227-2210
Practice Address - Country:US
Practice Address - Phone:410-789-2647
Practice Address - Fax:410-789-8364
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2012-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC2023101Y00000X, 101YM0800X, 101YP2500X
MDSC1314101YA0400X
101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD292519Medicaid