Provider Demographics
NPI:1689914111
Name:MASON, SHANEKKA D (MSED)
Entity Type:Individual
Prefix:
First Name:SHANEKKA
Middle Name:D
Last Name:MASON
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 W BEAVER ST
Mailing Address - Street 2:
Mailing Address - City:ZELIENOPLE
Mailing Address - State:PA
Mailing Address - Zip Code:16063-1582
Mailing Address - Country:US
Mailing Address - Phone:724-452-4453
Mailing Address - Fax:724-452-6576
Practice Address - Street 1:5648 FRIENDSHIP AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-3610
Practice Address - Country:US
Practice Address - Phone:412-661-1827
Practice Address - Fax:412-661-1867
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-20
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional