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General NPI Number Information
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NPI Number | 1255651824
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Entity Type | Individual
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Provider Name | GREGORY ALAN MASON LPC CMHC
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Gender | Male
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Dates
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Enumeration Date | 06/07/2010
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Last Update Date | 09/13/2013
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Provider Practice Location Address
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Address Line | 1916 N 700 W SUITE 241
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City | LAYTON
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State | UT
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Zip | 84041-5673
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Country | US
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Telephone | 801-690-3502
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Fax |
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Provider Business Mailing Address
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Address Line | 475 N 300 W SUITE 10
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City | KAYSVILLE
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State | UT
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Zip | 84037-3125
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Country | US
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Telephone | 801-690-3502
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Fax | 801-546-3422
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6822241-6004
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 68222416004
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License Number State | UT
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