Doctor Name: | MRS. STACEY MASON |
NPI Number: | 1073670501 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 2000172763 |
Business Practice Address: | 200 Ne Missouri Rd Suite 302 Lees Summit, MO - 640864720 |
Business Phone Number: | 8165230103 |
Business Fax Number: | 8163616471 |
Mailing Address: | 200 Ne Missouri Rd, Suite 302 LEES SUMMIT |
State: | MO |
Postal Code: | 640864720 |
Phone Number: | 8165230103 |
Fax Number: | 8163616471 |
NPI Enumeration Date: | 01/03/2007 |
NPI Last Update Date: | 01/08/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 2000172763 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |