Provider Demographics
NPI:1780467571
Name:MASSAQUOI, FATIMA (LMSW)
Entity type:Individual
Prefix:
First Name:FATIMA
Middle Name:
Last Name:MASSAQUOI
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613 DENHAM RD
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20851-1035
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3465 FORT MEADE RD # 109
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20724-2044
Practice Address - Country:US
Practice Address - Phone:240-863-2117
Practice Address - Fax:240-912-9564
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-15
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171W00000X
MD27208104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171W00000XOther Service ProvidersContractor