Provider Demographics
NPI:1497042014
Name:TERRY-MASON, ANITA SHYRELL (M ED LMHC, CADAC)
Entity Type:Individual
Prefix:MS
First Name:ANITA
Middle Name:SHYRELL
Last Name:TERRY-MASON
Suffix:
Gender:F
Credentials:M ED LMHC, CADAC
Other - Prefix:MS
Other - First Name:ANITA
Other - Middle Name:SHYRELL
Other - Last Name:MASON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:243 BROADWAY
Mailing Address - Street 2:APT., # 209
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-1957
Mailing Address - Country:US
Mailing Address - Phone:617-547-0166
Mailing Address - Fax:
Practice Address - Street 1:243 BROADWAY
Practice Address - Street 2:APT., # 209
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-1957
Practice Address - Country:US
Practice Address - Phone:617-547-0166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-03
Last Update Date:2011-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171W00000XOther Service ProvidersContractor