Provider Information for 1457981102
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Mr. MICHAEL RAYMOND MASTERS LCSW
Sex: Male
NPI: 1457981102
Last Updated: 2023-03-07
Certification Date: 2023-03-07
Certification Date: 2023-03-07
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1457981102 | ||||||||||||
| Enumeration Date | 2020-01-22 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 3 WASHINGTON SQUARE VLG APT 6D NEW YORK, NY 10012-1803 United States Phone: 347-749-0858 | Fax: | ||||||||||||
| Primary Practice Address | 3 WASHINGTON SQUARE VLG APT 6D NEW YORK, NY 10012-1803 United States Phone: 347-749-0858 | Fax: | ||||||||||||
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