Provider Demographics
NPI:1801182936
Name:NELSON - MASON, LATOYA MCDOUGAL (MA, LPC)
Entity Type:Individual
Prefix:MRS
First Name:LATOYA
Middle Name:MCDOUGAL
Last Name:NELSON - MASON
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:LATOYA
Other - Middle Name:MCDOUGAL
Other - Last Name:NELSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC, LCMHC
Mailing Address - Street 1:6325 FALLS OF NEUSE RD STE 35 - 389
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-6884
Mailing Address - Country:US
Mailing Address - Phone:919-410-6707
Mailing Address - Fax:
Practice Address - Street 1:6325 FALLS OF NEUSE RD STE 35 - 389
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-6884
Practice Address - Country:US
Practice Address - Phone:919-410-6707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-27
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10155101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health