Provider Demographics
NPI:1023249414
Name:MASTROPAOLO, JASON VINCENT (LCSW)
Entity type:Individual
Prefix:MR
First Name:JASON
Middle Name:VINCENT
Last Name:MASTROPAOLO
Suffix:
Gender:M
Credentials:LCSW
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Mailing Address - Street 1:2094 ALBANY POST RD
Mailing Address - Street 2:VA HUDSON VALLEY HEALTH CARE SYSTEM
Mailing Address - City:MONTROSE
Mailing Address - State:NY
Mailing Address - Zip Code:10548-1454
Mailing Address - Country:US
Mailing Address - Phone:914-737-4400
Mailing Address - Fax:914-788-4286
Practice Address - Street 1:2094 ALBANY POST RD
Practice Address - Street 2:VA HUDSON VALLEY HEALTH CARE SYSTEM
Practice Address - City:MONTROSE
Practice Address - State:NY
Practice Address - Zip Code:10548-1454
Practice Address - Country:US
Practice Address - Phone:914-737-4400
Practice Address - Fax:914-788-4286
Is Sole Proprietor?:No
Enumeration Date:2009-08-03
Last Update Date:2013-03-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY0771681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY$$$$$$$$$OtherSOCIAL SECURITY NUMBER