Provider Demographics
NPI:1033973730
Name:MAST, CORTNEY RENEE (LCSW)
Entity Type:Individual
Prefix:
First Name:CORTNEY
Middle Name:RENEE
Last Name:MAST
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 10 BOX 1174
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09142-0012
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:LANDSTUHL REGIONAL MEDICAL CENTER
Practice Address - Street 2:DR. HITZELBERGER STRASSE
Practice Address - City:LANSTUHL
Practice Address - State:RHINELAND-PFALZ
Practice Address - Zip Code:66849
Practice Address - Country:DE
Practice Address - Phone:314-590-4913
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-13
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI50941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical