MEDICARE: ANNE MASSON LCSW

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	1041C0700X	Clinical Social Worker	S34349	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	86525Q	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1790737823
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNE MASSON LCSW

Provider Business Mailing Address
First Line	:	17820 WINDFLOWER WAY UNIT 1002
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75252-5210
Country	:	US
Telephone Number	:	972-571-2450
Fax Number	:

Provider Business Practice Location Address
First Line	:	17820 WINDFLOWER WAY UNIT 1002
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75252-5210
Country	:	US
Telephone Number	:	972-571-2450
Fax Number	:

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

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	04/21/2011

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Directions to “ ANNE MASSON LCSW” Practice Location

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