Provider Demographics
NPI:1740152800
Name:DASHIA, PHILSON A SR
Entity type:Individual
Prefix:
First Name:PHILSON
Middle Name:A
Last Name:DASHIA
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2398 TREE VISTA CT
Mailing Address - Street 2:
Mailing Address - City:BRYANS ROAD
Mailing Address - State:MD
Mailing Address - Zip Code:20616-6117
Mailing Address - Country:US
Mailing Address - Phone:612-702-0676
Mailing Address - Fax:
Practice Address - Street 1:2398 TREE VISTA CT
Practice Address - Street 2:
Practice Address - City:BRYANS ROAD
Practice Address - State:MD
Practice Address - Zip Code:20616-6117
Practice Address - Country:US
Practice Address - Phone:612-702-0676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-19
Last Update Date:2025-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty