Healthcare Provider Details

I. General information

NPI: 1811689292
Provider Name (Legal Business Name): LISA ANN MASON LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LISA ANN SCHLESSINGER

II. Dates (important events)

Enumeration Date: 05/23/2023
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 LYNDHURST DR
SAINT AUGUSTINE FL
32092-1092
US

IV. Provider business mailing address

1900 LYNDHURST DR
SAINT AUGUSTINE FL
32092-1092
US

V. Phone/Fax

Practice location:
  • Phone: 904-861-4331
  • Fax:
Mailing address:
  • Phone: 904-861-4331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH25494
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: