Healthcare Provider Details

I. General information

NPI: 1982194957
Provider Name (Legal Business Name): BRIANNA MASON LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2018
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16520 N GREASEWOOD ST UNIT 1015
SURPRISE AZ
85378-3501
US

IV. Provider business mailing address

16520 N GREASEWOOD ST UNIT 1015
SURPRISE AZ
85378-3501
US

V. Phone/Fax

Practice location:
  • Phone: 315-212-8396
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number001510
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: