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General NPI Number Information
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NPI Number | 1346289840
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Entity Type | Individual
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Provider Name | RICHARD LEE MASON CADC
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Gender | Male
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Dates
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Enumeration Date | 06/06/2006
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Last Update Date | 11/07/2013
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Provider Practice Location Address
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Address Line | 1030 E 18TH ST
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City | OWENSBORO
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State | KY
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Zip | 42303-4733
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Country | US
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Telephone | 277-240-5005
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Fax | 270-240-5007
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Provider Business Mailing Address
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Address Line | 1030 E 18TH ST
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City | OWENSBORO
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State | KY
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Zip | 42303-4733
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Country | US
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Telephone | 270-240-5005
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Fax | 270-240-5007
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 0441
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License Number State | KY
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