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NPI Code Detail

MEDICARE: MR. JAMES J MASTERSON M.S.W.

MEDICARE: MR. JAMES J MASTERSON M.S.W.
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 Counselor979008CO

General Provider Information

NPI Number : 1831179324
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JAMES J MASTERSON M.S.W.
Provider Business Mailing Address
First Line : 15637 E POWERS DR
Second Line :
City : CENTENNIAL
State : CO
Zip : 80015-4242
Country : US
Telephone Number : 303-338-8578
Fax Number : 303-861-6209
Provider Business Practice Location Address
First Line : 2101 S BLACKHAWK ST
Second Line :
City : AURORA
State : CO
Zip : 80014-1475
Country : US
Telephone Number : 303-338-8578
Fax Number : 303-861-6209
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2006
Last Update Date : 07/08/2007

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