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General NPI Number Information
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NPI Number | 1932555901
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Entity Type | Individual
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Provider Name | KATHLEEN MICHELE MASTON LMSW
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Gender | Female
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Dates
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Enumeration Date | 05/10/2016
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Last Update Date | 01/10/2019
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Provider Practice Location Address
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Address Line | 7809 AIRLINE DR STE 209
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City | METAIRIE
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State | LA
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Zip | 70003-6440
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Country | US
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Telephone | 504-516-2162
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Fax | 504-516-2197
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Provider Business Mailing Address
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Address Line | 7809 AIRLINE DR STE 209
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City | METAIRIE
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State | LA
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Zip | 70003-6440
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Country | US
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Telephone | 504-331-8935
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Fax | 504-516-2197
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 10033
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | 103229
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | 10033
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License Number State | LA
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