MEDICARE: ROCHELLE E MASON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor		OK
2	1041C0700X	Clinical Social Worker	5298	OK
3	104100000X	Social Worker		OK

General Provider Information

NPI Number	:	1962845560
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROCHELLE E MASON

Provider Business Mailing Address
First Line	:	807 SW F AVE
Second Line	:
City	:	LAWTON
State	:	OK
Zip	:	73501-4506
Country	:	US
Telephone Number	:	580-595-7000
Fax Number	:

Provider Business Practice Location Address
First Line	:	4303 PITMAN ST BLDG 4303
Second Line	:
City	:	FORT SILL
State	:	OK
Zip	:	73503-4473
Country	:	US
Telephone Number	:	580-585-5600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2013
Last Update Date	:	07/21/2022

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Directions to “ ROCHELLE E MASON ” Practice Location

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