Provider Demographics
NPI:1134936677
Name:MASON, SHAUN ESSIE (BS , MED, LPC)
Entity type:Individual
Prefix:MR
First Name:SHAUN
Middle Name:ESSIE
Last Name:MASON
Suffix:
Gender:M
Credentials:BS , MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 OLD BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23608-5049
Mailing Address - Country:US
Mailing Address - Phone:757-277-5377
Mailing Address - Fax:
Practice Address - Street 1:181 OLD BRIDGE RD
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23608-5049
Practice Address - Country:US
Practice Address - Phone:757-277-5377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-17
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701014245101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional