Provider Demographics
NPI:1861919433
Name:MAAS, VICTOR
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:
Last Name:MAAS
Suffix:
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 1:1204 S WASHINGTON ST APT 505
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-4450
Mailing Address - Country:US
Mailing Address - Phone:703-772-7018
Mailing Address - Fax:
Practice Address - Street 1:8348 TRAFORD LN STE 400
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22152-1650
Practice Address - Country:US
Practice Address - Phone:703-866-2100
Practice Address - Fax:703-653-7024
Is Sole Proprietor?:No
Enumeration Date:2017-08-24
Last Update Date:2017-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040099981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical