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NPI Code Detail

MEDICARE: TAYLOR LEIGH MASON

MEDICARE: TAYLOR LEIGH 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
1101YA0400XAddiction (Substance Use Disorder) Counselor
21041C0700XClinical Social WorkerS.2100695OH

General Provider Information

NPI Number : 1508456922
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAYLOR LEIGH MASON
Provider Business Mailing Address
First Line : PO BOX 55
Second Line :
City : WALTON
State : KY
Zip : 41094-0055
Country : US
Telephone Number : 740-270-3286
Fax Number :
Provider Business Practice Location Address
First Line : 95 S MULBERRY ST
Second Line :
City : LOGAN
State : OH
Zip : 43138-1240
Country : US
Telephone Number : 740-270-3286
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2021
Last Update Date : 01/31/2022

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Directions to “ TAYLOR LEIGH MASON ” Practice Location

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