Healthcare Provider Details

I. General information

NPI: 1750553194
Provider Name (Legal Business Name): CHRISTINE ELIZABETH MASON PSYD, LP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTINE MASON NAVRAT PSY D, LP

II. Dates (important events)

Enumeration Date: 03/26/2008
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 HART BLVD
MONTICELLO MN
55362-8670
US

IV. Provider business mailing address

1001 HART BLVD
MONTICELLO MN
55362-8670
US

V. Phone/Fax

Practice location:
  • Phone: 763-271-2276
  • Fax: 320-229-5109
Mailing address:
  • Phone: 763-271-2276
  • Fax: 320-229-5109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberLO5030
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberLP5030
License Number StateMN
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number017436
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: