Healthcare Provider Details
I. General information
NPI: 1841453149
Provider Name (Legal Business Name): KARIS MASON LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/07/2008
Last Update Date: 12/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5700 PERIMETER DR
DUBLIN OH
43017-3247
US
IV. Provider business mailing address
PO BOX 715194
COLUMBUS OH
43271-5194
US
V. Phone/Fax
- Phone: 614-355-9580
- Fax: 614-355-9589
- Phone: 614-355-8004
- Fax: 614-355-0509
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | E.0500019 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: