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General NPI Number Information
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NPI Number | 1770102733
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Entity Type | Individual
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Provider Name | JANNA MARIE MASON MS, LPCC, NCC
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Gender | Female
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Dates
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Enumeration Date | 04/10/2020
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Last Update Date | 08/09/2023
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Provider Practice Location Address
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Address Line | 12800 WHITEWATER DR STE 100
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City | MINNETONKA
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State | MN
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Zip | 55343-9347
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Country | US
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Telephone | 612-562-6605
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Fax |
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Provider Business Mailing Address
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Address Line | 12800 WHITEWATER DR STE 100
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City | MINNETONKA
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State | MN
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Zip | 55343-9347
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Country | US
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Telephone | 307-689-1818
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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 | BBH-LCPC-LIC-62412
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 2441
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License Number State | MN
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