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General NPI Number Information
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NPI Number | 1770147886
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Entity Type | Individual
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Provider Name | JOHN-PAUL MASSON MSW, RCSWI
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Gender | Male
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Dates
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Enumeration Date | 04/24/2019
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Last Update Date | 04/24/2019
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Provider Practice Location Address
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Address Line | 1414 NW 107TH AVE
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City | SWEETWATER
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State | FL
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Zip | 33172-2732
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Country | US
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Telephone | 954-399-2162
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Fax |
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Provider Business Mailing Address
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Address Line | 957 NW 79TH TER
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City | PLANTATION
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State | FL
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Zip | 33324-1476
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Country | US
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Telephone |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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