MEDICARE: MS. CYNTHIA J. MASON LPCC/SC, LICDC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	21214	OH
2	101YM0800X	Mental Health Counselor	E2186	OH

General Provider Information

NPI Number	:	1689844383
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CYNTHIA J. MASON LPCC/SC, LICDC

Provider Business Mailing Address
First Line	:	7561 HI VIEW DR
Second Line	:
City	:	N ROYALTON
State	:	OH
Zip	:	44133-3815
Country	:	US
Telephone Number	:	440-582-9826
Fax Number	:	216-698-6601

Provider Business Practice Location Address
First Line	:	5706 TURNEY RD
Second Line	:
City	:	GARFIELD HEIGHTS
State	:	OH
Zip	:	44125-3971
Country	:	US
Telephone Number	:	216-420-6834
Fax Number	:

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

Provider Enumeration Date	:	03/10/2008
Last Update Date	:	03/10/2008

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