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General NPI Number Information
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NPI Number | 1962754408
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Entity Type | Individual
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Provider Name | CANDACE LEE MASON MA, LPC-S, NCC, CFRC
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Gender | Female
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Dates
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Enumeration Date | 10/08/2012
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Last Update Date | 04/19/2024
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Provider Practice Location Address
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Address Line | 4460 OKEMOS RD STE 21
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City | OKEMOS
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State | MI
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Zip | 48864-2553
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Country | US
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Telephone | 517-974-2402
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Fax |
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Provider Business Mailing Address
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Address Line | 5815 BENT TREE DR
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City | EAST LANSING
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State | MI
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Zip | 48823-7789
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Country | US
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Telephone | 517-974-2402
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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 | 6401013260
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License Number State | MI
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