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General NPI Number Information
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NPI Number | 1386115434
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Entity Type | Individual
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Provider Name | BENJAMIN MASON JUDY MA, LMHC
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Gender | Male
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Dates
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Enumeration Date | 12/16/2018
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Last Update Date | 04/18/2022
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Provider Practice Location Address
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Address Line | 819 N 49TH ST UNIT 229
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City | SEATTLE
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State | WA
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Zip | 98103-6569
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Country | US
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Telephone | 253-294-9429
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Fax |
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Provider Business Mailing Address
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Address Line | 2501 SW TRENTON ST # 1001
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City | SEATTLE
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State | WA
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Zip | 98106-3206
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Country | US
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Telephone | 253-294-9429
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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 | LH61166828
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License Number State | WA
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