Provider Demographics
NPI:1356008817
Name:MASON, JOSH (CAS MA)
Entity Type:Individual
Prefix:
First Name:JOSH
Middle Name:
Last Name:MASON
Suffix:
Gender:M
Credentials:CAS MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12300 HIGHWAY 491 # 3
Mailing Address - Street 2:
Mailing Address - City:CORTEZ
Mailing Address - State:CO
Mailing Address - Zip Code:81321-9398
Mailing Address - Country:US
Mailing Address - Phone:970-903-5549
Mailing Address - Fax:
Practice Address - Street 1:12300 HIGHWAY 491 # 3
Practice Address - Street 2:
Practice Address - City:CORTEZ
Practice Address - State:CO
Practice Address - Zip Code:81321-9398
Practice Address - Country:US
Practice Address - Phone:970-903-5549
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-19
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACC.0998486101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)