Individual
MARK E MODOSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW-C
Contact information
Practice address
2700 WILLOW OAK DR APT 112, CAMBRIDGE, MD 21613-3539
(443) 521-9525
Mailing address
2700 WILLOW OAK DR APT 112, CAMBRIDGE, MD 21613-3539
(443) 521-9525
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
37LC00298800
NJ
101YM0800X
Mental Health Counselor
Primary
27003
MD
Other
Enumeration date
05/03/2021
Last updated
05/03/2021
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