Provider Demographics
NPI:1265003735
Name:MASON, AMANDA CHRISTINE (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:CHRISTINE
Last Name:MASON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MS
Other - First Name:AMANDA
Other - Middle Name:CHRISTINE
Other - Last Name:MASON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:76 REDWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:JIM THORPE
Mailing Address - State:PA
Mailing Address - Zip Code:18229
Mailing Address - Country:US
Mailing Address - Phone:724-882-7998
Mailing Address - Fax:
Practice Address - Street 1:76 REDWOOD DRIVE
Practice Address - Street 2:
Practice Address - City:JIM THORPE
Practice Address - State:PA
Practice Address - Zip Code:18229
Practice Address - Country:US
Practice Address - Phone:724-882-7998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-06
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA12209101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health