Provider Demographics
NPI:1427166545
Name:MASCI, TANYA MARIA (MSW, LCSW)
Entity type:Individual
Prefix:MRS
First Name:TANYA
Middle Name:MARIA
Last Name:MASCI
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12390 SWAN WINGS PL
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-2343
Mailing Address - Country:US
Mailing Address - Phone:704-947-8143
Mailing Address - Fax:
Practice Address - Street 1:10225 HICKORYWOOD HILL AVE
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-3307
Practice Address - Country:US
Practice Address - Phone:704-992-1359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC004421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical