Provider Demographics
NPI:1356668040
Name:MASONJONES, CYNTHIA LOU (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:LOU
Last Name:MASONJONES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 MAIN ST
Mailing Address - Street 2:6
Mailing Address - City:MYSTIC
Mailing Address - State:CT
Mailing Address - Zip Code:06355-3654
Mailing Address - Country:US
Mailing Address - Phone:860-572-4969
Mailing Address - Fax:860-572-5767
Practice Address - Street 1:11 MAIN ST
Practice Address - Street 2:6
Practice Address - City:MYSTIC
Practice Address - State:CT
Practice Address - Zip Code:06355-3654
Practice Address - Country:US
Practice Address - Phone:860-572-4969
Practice Address - Fax:860-572-5767
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-21
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT58.0072861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical