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General NPI Number Information
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NPI Number | 1538207667
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Entity Type | Organization
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Legal Business Name | JOAN S MASON LCSW CAP P A
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Dates
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Enumeration Date | 02/01/2007
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Last Update Date | 11/16/2012
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Provider Practice Location Address
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Address Line | 3321 49TH ST N
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City | ST PETERSBURG
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State | FL
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Zip | 33710-2145
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Country | US
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Telephone | 727-743-9060
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Fax | 727-367-4139
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Provider Business Mailing Address
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Address Line | 200 1ST AVE #305
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City | ST PETE BEACH
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State | FL
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Zip | 33706-4364
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Country | US
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Telephone | 727-744-4880
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Fax | 727-367-4139
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Authorized Official
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Title or Position | OWNER
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Name | JOAN S MASON
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Credential | LCSW
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Telephone | 727-743-9060
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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 | SW4600
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License Number State | FL
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