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NPI Code Detail

MEDICARE: ALIDA S MASON LCSW PLLC

MEDICARE: ALIDA S MASON LCSW PLLC
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 Counselor5199NC
2103T00000XPsychologist1347NC
3103T00000XPsychologist3183NC
41041C0700XClinical Social Worker1738NC
5261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)36397NC
6101YA0400XAddiction (Substance Use Disorder) Counselor243NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1245316173
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALIDA S MASON LCSW PLLC
Provider Business Mailing Address
First Line : 806 STAMPER RD
Second Line : STE 201
City : FAYETTEVILLE
State : NC
Zip : 28303-4375
Country : US
Telephone Number : 910-221-5269
Fax Number : 910-221-9006
Provider Business Practice Location Address
First Line : 806 STAMPER RD
Second Line : STE 201
City : FAYETTEVILLE
State : NC
Zip : 28303-4100
Country : US
Telephone Number : 910-221-5269
Fax Number : 910-221-9006
Authorized Official
Title or Position : OFFICE MANAGER
Name : MS. ANN LUCINDA LEE
Credential :
Telephone Number : 910-221-5269
Provider Enumeration Date : 10/31/2006
Last Update Date : 09/11/2025

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Directions to “ALIDA S MASON LCSW PLLC ” Practice Location

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