Provider Demographics
NPI:1093084618
Name:MASON, ELIZABETH ANN (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ANN
Last Name:MASON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2214 NORTH ATHERTON STREET
Mailing Address - Street 2:SUITE 4
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16803
Mailing Address - Country:US
Mailing Address - Phone:814-237-0567
Mailing Address - Fax:
Practice Address - Street 1:2214 N ATHERTON ST
Practice Address - Street 2:SUITE 4
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16803-1544
Practice Address - Country:US
Practice Address - Phone:814-237-0567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-28
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW129169104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker