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NPI Code Detail

MEDICARE: SARAH VINICOR MASON LCSW

MEDICARE: SARAH VINICOR MASON 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
1104100000XSocial WorkerL2823OR
2101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1932295672
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH VINICOR MASON LCSW
Provider Business Mailing Address
First Line : PO BOX 100
Second Line :
City : ALBANY
State : OR
Zip : 97321-0031
Country : US
Telephone Number : 541-967-3866
Fax Number : 541-928-3020
Provider Business Practice Location Address
First Line : 2730 PACIFIC BLVD SE
Second Line :
City : ALBANY
State : OR
Zip : 97321-5075
Country : US
Telephone Number : 541-967-9866
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2006
Last Update Date : 03/17/2018

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Directions to “ SARAH VINICOR MASON LCSW” Practice Location

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