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Individual

JAIME MASTRORIO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
32 CLARK ST, PORTLAND, ME 04102-4100
(508) 243-3580
(207) 878-2259
Mailing address
32 CLARK ST APT B, PORTLAND, ME 04102-4112
(508) 243-3580

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC18378
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
LC18378
LICENSE MAINE
ME
01
MC16717
LICENSE MAINE
ME
Enumeration date
10/04/2017
Last updated
07/04/2022
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