MARY MASCOLO (NPI# 1245414440) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245414440 |
| Entity Type | Individual |
| Full Name | MARY MASCOLO |
| Credential | LADC |
| Practice Address |
130 Division Street Griffin Hospital Derby CT 06418 |
| Practice Telephone | 2037327550 |
| Practice Fax Number | 2037321550 |
| Mailing Telephone | 2037327550 |
| Mailing Fax Number | 2037321550 |
| Enumeration Date | 2007-12-24 |
| Last Update Date | 2007-12-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
00364 | CT | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | LICENSE NUMBER | 00364 | 01 |
| Street Address |
130 DIVISION STREET GRIFFIN HOSPITAL |
| City | DERBY |
| State | CT |
| Zip Code | 06418 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497818462 | Kenneth S Spector | Internal Medicine | 130 Division Street, Derby, CT 06418 | 2006-12-19 |
| 1790305159 | Inshiya Lowai Dawoodi | Student in an Organized Health Care Education/Training Program | 130 Division Street, Griffin Hospital, Derby, CT 06418 | 2020-04-25 |
| 1437647468 | Nisar Muhammad Khan | Student in an Organized Health Care Education/Training Program | 130 Division Street, Derby, CT 06418 | 2018-04-25 |
| 1760881338 | Julie Shattuck Heher | Nurse Practitioner | 130 Division Street, Derby, CT 06418-1326 | 2014-08-19 |
| 1649689415 | Ashley Dizney | Nurse Practitioner | 130 Division Street, Derby, CT 06418-1326 | 2014-08-06 |
| 1912324815 | Melissa Mitri | Dietitian, Registered | 130 Division Street, Derby, CT 06418 | 2014-03-28 |
| 1225368954 | Brooke Lillie | Counselor | 130 Division Street, Griffin Hospital, Derby, CT 06418 | 2009-12-31 |
| 1659511095 | Gloria Dzerovych | Social Worker | 130 Division Street, Griffin Hospital, Derby, CT 06418 | 2009-02-25 |
| 1588803381 | Rita Tropper | Social Worker | 130 Division Street, Griffin Hospital, Derby, CT 06418 | 2009-02-18 |
| 1053565762 | Thomas Heffernan | Counselor | 130 Division Street, Griffin Hospital, Derby, CT 06418 | 2008-11-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942839105 | Fnu Prinkiya | Student in an Organized Health Care Education/Training Program | Griffin Hospital. 130 Division St, Derby, CT 06418 | 2020-04-08 |
| 1942837935 | Ivanshi A Gondalia | Student in an Organized Health Care Education/Training Program | Griffin Hospital, 130 Division St, Derby, CT 06418 | 2020-03-27 |
| 1972168094 | Pir Saad | Student in an Organized Health Care Education/Training Program | C/o Margie Bliga, Department of Medical Education, Griffin Hospital, 130 Division St, Derby, CT 06418 | 2019-05-03 |
| 1295398899 | Ahtsham Yousaf Chaudhary | Student in an Organized Health Care Education/Training Program | 130 Division St, Griffin Hospital, Derby, CT 06418 | 2019-04-18 |
| 1477016376 | Rabia Usman | Student in an Organized Health Care Education/Training Program | 130 Division St. Griffin Hospital, Derby, CT 06418 | 2019-04-09 |
| 1932661428 | Meshal Qaiser | Student in an Organized Health Care Education/Training Program | 130 Division Street Griffin Hospital, Derby, CT 06418 | 2019-04-03 |
| 1275027666 | Victoria Anne Hodge Enquist | Social Worker | 241 Seymour Avenue, Griffin Hospital Iop, Seymour, CT 06418 | 2018-06-19 |
| 1811485758 | Nimeshayan Varatharajah | Student in an Organized Health Care Education/Training Program | Griffin Hospital, 130 Division St., Derby, CT 06418 | 2018-04-26 |
| 1851889836 | Pete Prashamsa Shenoy | Student in an Organized Health Care Education/Training Program | Griffin Hospital (dpt of Graduate Medical Education), 130 Division St., Derby, CT 06418 | 2018-04-25 |
| 1639696594 | Samantha Leigh Bassett | Counselor | 90 Sodom Lane, Derby, CT 06418 | 2017-08-23 |
| Find all providers in zip 06418 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720612591 | Elizabeth Belen | Counselor | 15 Mason St, Derby, CT 06418-1420 | 2020-03-02 |
| 1376906487 | Glenn Sherwood | Counselor | 425 N Baltimore Ave Ste 1, Derby, KS 67037-1625 | 2016-04-05 |
| 1538505573 | Deborah Sue Bianchi | Counselor | 3212 Us Route 5, Derby, VT 05829-9677 | 2013-05-16 |
| 1023316494 | Tony J Graveline | Counselor | 181 Crawford Road, Derby, VT 05829 | 2011-03-08 |
| 1619115946 | Katrinka Sherron Ivie | Counselor | 119 S Baltimore Ave, Derby, KS 67037-1403 | 2009-01-23 |
| 1518116201 | Maryellen Gallagher | Counselor | 130 Division St., Griffin Hospital, Derby, CT 06418 | 2008-09-17 |
| 1760680177 | Glenn K Sherwood | Counselor | 421 N Baltimore Ave Ste 1, Derby, KS 67037-1605 | 2007-07-06 |
| 1366088825 | Marie N Mcgregor | Counselor | 181 Crawford Road, Derby, VT 05829 | 2019-11-20 |
| 1811417256 | Thomas J Halligan Jr. | Counselor | 181 Crawford Road, Derby, VT 05829 | 2017-06-27 |
| 1619335916 | Johan Green | Counselor | 181 Crawford Road, Derby, VT 05829 | 2016-02-02 |
| Find all providers in DERBY | ||||
Please comment or provide details below to improve the information on MARY MASCOLO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.