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NPI Code Detail

MEDICARE: ELIETRENAY MASON

MEDICARE:   ELIETRENAY  MASON
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
1101YM0800XMental Health CounselorPLC10034LA
2171M00000XCase Manager/Care Coordinator
3171M00000XCase Manager/Care CoordinatorPLC10034LA

General Provider Information

NPI Number : 1235703810
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIETRENAY MASON
Provider Business Mailing Address
First Line : 9771 JEFFERSON HWY APT 33
Second Line :
City : BATON ROUGE
State : LA
Zip : 70809-2701
Country : US
Telephone Number : 225-288-3103
Fax Number :
Provider Business Practice Location Address
First Line : 615 CHEVELLE CT
Second Line :
City : BATON ROUGE
State : LA
Zip : 70806-6502
Country : US
Telephone Number : 225-303-0212
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2021
Last Update Date : 12/27/2024

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Directions to “ ELIETRENAY MASON ” Practice Location

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