Provider Demographics
NPI:1598382533
Name:MASON, PATRICIA MITCHELL (CDCA)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:MITCHELL
Last Name:MASON
Suffix:
Gender:F
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 W MARKET ST # 223
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-7002
Mailing Address - Country:US
Mailing Address - Phone:216-407-4861
Mailing Address - Fax:
Practice Address - Street 1:275 GRAHAM RD STE 2
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44223-2259
Practice Address - Country:US
Practice Address - Phone:216-407-4861
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-25
Last Update Date:2020-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA.150839101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)