Provider Demographics
NPI:1851062525
Name:MASAT, BRIAN
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:MASAT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11023 MORROW DR
Mailing Address - Street 2:
Mailing Address - City:SAINT ANN
Mailing Address - State:MO
Mailing Address - Zip Code:63074-3318
Mailing Address - Country:US
Mailing Address - Phone:314-925-0330
Mailing Address - Fax:
Practice Address - Street 1:9733 SAINT CHARLES ROCK RD
Practice Address - Street 2:
Practice Address - City:BRECKENRIDGE HILLS
Practice Address - State:MO
Practice Address - Zip Code:63114-2625
Practice Address - Country:US
Practice Address - Phone:314-423-7030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-23
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007007068101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)