Provider Demographics
NPI:1417046749
Name:MASONE, KARINE (LCSW,CASAC)
Entity Type:Individual
Prefix:MS
First Name:KARINE
Middle Name:
Last Name:MASONE
Suffix:
Gender:F
Credentials:LCSW,CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:336 32ND ST
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11757-3231
Mailing Address - Country:US
Mailing Address - Phone:631-226-0248
Mailing Address - Fax:
Practice Address - Street 1:538 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:RIVERHEAD
Practice Address - State:NY
Practice Address - Zip Code:11901-2743
Practice Address - Country:US
Practice Address - Phone:631-226-0248
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY072603-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNU9731Medicare ID - Type Unspecified