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General NPI Number Information
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NPI Number | 1629775374
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Entity Type | Individual
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Provider Name | NEFERTIA Y MASON M.ED, LPCC, NBCC
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Gender | Female
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Dates
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Enumeration Date | 02/13/2023
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Last Update Date | 02/13/2023
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Provider Practice Location Address
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Address Line | 1939 GOLDSMITH LN STE 130
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City | LOUISVILLE
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State | KY
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Zip | 40218-3175
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Country | US
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Telephone | 502-822-3178
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Fax |
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Provider Business Mailing Address
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Address Line | 1600 LOUIS COLEMAN JR DR
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City | LOUISVILLE
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State | KY
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Zip | 40211-1809
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Country | US
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Telephone | 502-416-8060
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 275596
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License Number State | KY
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