Healthcare Provider Details

I. General information

NPI: 1356613863
Provider Name (Legal Business Name): RIMA A. MASON, MA, LPC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2012
Last Update Date: 01/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 LAKESHORE DR
OAKLAND NJ
07436-2104
US

IV. Provider business mailing address

PO BOX 1202
OAKLAND NJ
07436-6202
US

V. Phone/Fax

Practice location:
  • Phone: 551-427-5101
  • Fax:
Mailing address:
  • Phone: 551-427-5101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37PC00420400
License Number StateNJ

VIII. Authorized Official

Name: MS. RIMA MASON
Title or Position: FOUNDER & PRESIDENT
Credential: LPC
Phone: 551-427-5101