Provider Demographics
NPI:1649002031
Name:MASON, MEREDITH (MA, LMHC)
Entity type:Individual
Prefix:MRS
First Name:MEREDITH
Middle Name:
Last Name:MASON
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1445 WAMPANOAG TRL UNIT 202
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:RI
Mailing Address - Zip Code:02915-1019
Mailing Address - Country:US
Mailing Address - Phone:774-307-9365
Mailing Address - Fax:
Practice Address - Street 1:1445 WAMPANOAG TRL UNIT 202
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:RI
Practice Address - Zip Code:02915-1019
Practice Address - Country:US
Practice Address - Phone:774-307-9365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-15
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMHC01722101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health