Provider Demographics
NPI:1942524830
Name:MASON, MICHAEL JEFFREY (PHD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JEFFREY
Last Name:MASON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:582 SCARBOROUGH RD
Mailing Address - Street 2:
Mailing Address - City:BRIARCLIFF MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10510-2020
Mailing Address - Country:US
Mailing Address - Phone:914-645-0723
Mailing Address - Fax:914-941-1199
Practice Address - Street 1:1607 ROUTE 300
Practice Address - Street 2:SUITE 102
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-1738
Practice Address - Country:US
Practice Address - Phone:914-645-0723
Practice Address - Fax:914-941-1199
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-21
Last Update Date:2010-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001422101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health