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General NPI Number Information
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NPI Number | 1023871209
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Entity Type | Individual
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Provider Name | KAI TAYLOR MASON MA, LADC, LPCC
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Gender | Female
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Dates
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Enumeration Date | 01/31/2024
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Last Update Date | 01/31/2024
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Provider Practice Location Address
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Address Line | 8640 EAGLE CREEK CIR
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City | SAVAGE
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State | MN
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Zip | 55378-4400
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Country | US
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Telephone | 952-746-7664
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Fax |
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Provider Business Mailing Address
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Address Line | 15645 24TH AVE N UNIT H
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City | PLYMOUTH
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State | MN
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Zip | 55447-6462
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Country | US
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Telephone | 651-274-5770
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | CC04227
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License Number State | MN
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