Provider Demographics
NPI:1689359200
Name:MASON, YOULONDA CANDIDA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:YOULONDA
Middle Name:CANDIDA
Last Name:MASON
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 1:113 PINE TREE PATH APT 1
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40324-8781
Mailing Address - Country:US
Mailing Address - Phone:859-397-0804
Mailing Address - Fax:
Practice Address - Street 1:561 BRECKENRIDGE ST APT 201
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40508-2256
Practice Address - Country:US
Practice Address - Phone:859-618-7778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-20
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2581081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty