Provider Demographics
NPI:1316215940
Name:MASON, SHAREKA (PLPC)
Entity Type:Individual
Prefix:
First Name:SHAREKA
Middle Name:
Last Name:MASON
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13861 E 35TH CT S
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64055-2452
Mailing Address - Country:US
Mailing Address - Phone:660-232-9090
Mailing Address - Fax:
Practice Address - Street 1:5500 N OAK TRFY STE 204
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64118-4681
Practice Address - Country:US
Practice Address - Phone:816-510-0220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-10
Last Update Date:2011-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001039639101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional