Active NPI
Virginia Mastro
- Professional Counselor
- Salisbury, MD
National Provider Identifier
1184442386
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LGP15658
- Practice address
- 31575 Winterplace Pkwy
Salisbury, MD 21804-1882 - Phone
- (410) 642-4011
- Fax
- (410) 630-1654
- NPI assigned
- Sep 27, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LGP15658 | MD | Primary |
Addresses
Primary practice location
31575 Winterplace Pkwy
Salisbury, MD 21804-1882
Mailing address
1411 Wesley Dr
Salisbury, MD 21801-7149
Phone (410) 642-4011
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LGP15658 | MD | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Evolve Mental Wellness | Professional | Current | Accepting new patients |
Locations
1411 Wesley Dr
Salisbury, MD 21801
Phone (410) 642-4011
31575 Winterplace Pkwy
Salisbury, MD 21804
Phone (410) 546-0900
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1727395200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727395200000",
"number": "1184442386",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1411 WESLEY DR",
"city": "SALISBURY",
"state": "MD",
"postal_code": "218017149",
"telephone_number": "410-642-4011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "31575 WINTERPLACE PKWY",
"city": "SALISBURY",
"state": "MD",
"postal_code": "218041882",
"telephone_number": "410-642-4011",
"fax_number": "410-630-1654"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASTRO",
"first_name": "VIRGINIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-09-27",
"last_updated": "2024-09-27",
"certification_date": "2024-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MD",
"license": "LGP15658",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salisbury, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.