MEDICARE: MARIEL CHINOUYAZUE-MASON M.ED., LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	82380	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	82380	OTHER	TX	TEXAS STATE BOARD OF PROFESSIONAL COUNSELORS

General Provider Information

NPI Number	:	1154929818
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIEL CHINOUYAZUE-MASON M.ED., LPC

Provider Business Mailing Address
First Line	:	PO BOX 5857
Second Line	:
City	:	KINGWOOD
State	:	TX
Zip	:	77325-5857
Country	:	US
Telephone Number	:	832-233-3086
Fax Number	:	832-415-3050

Provider Business Practice Location Address
First Line	:	1801 KINGWOOD DR STE 200
Second Line	:
City	:	KINGWOOD
State	:	TX
Zip	:	77339-3059
Country	:	US
Telephone Number	:	832-233-3086
Fax Number	:	832-415-3050

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/15/2020
Last Update Date	:	03/21/2023

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