Provider Demographics
NPI:1225779473
Name:MASON, ABIGAIL (LPC)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:MASON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3122 HANES AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23222-2623
Mailing Address - Country:US
Mailing Address - Phone:757-618-6380
Mailing Address - Fax:
Practice Address - Street 1:7760 SHRADER RD STE B
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23228-2552
Practice Address - Country:US
Practice Address - Phone:804-591-0002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-03
Last Update Date:2022-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701010244101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional