Healthcare Provider Details
I. General information
NPI: 1750306262
Provider Name (Legal Business Name): ROBERT MASON L.C.S.W.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2540 MONROEVILLE BLVD
MONROEVILLE PA
15146-2329
US
IV. Provider business mailing address
2540 MONROEVILLE BLVD
MONROEVILLE PA
15146-2329
US
V. Phone/Fax
- Phone: 412-823-5155
- Fax: 412-823-8262
- Phone: 412-823-5155
- Fax: 412-823-8262
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | 4412 |
| Identifier Type | OTHER |
| Identifier State | PA |
| Identifier Issuer | UPMC |
| # 2 | |
| Identifier | 638875 |
| Identifier Type | OTHER |
| Identifier State | PA |
| Identifier Issuer | BC/BS |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: