Provider Demographics
NPI:1649365560
Name:MASON, JEFFREY A
Entity type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:A
Last Name:MASON
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 1:91 LINDA RD
Mailing Address - Street 2:
Mailing Address - City:TIVERTON
Mailing Address - State:RI
Mailing Address - Zip Code:02878
Mailing Address - Country:US
Mailing Address - Phone:401-339-3879
Mailing Address - Fax:
Practice Address - Street 1:2 OLD COUNTY RD
Practice Address - Street 2:EAST BAY MENTAL HEALTH CENTER
Practice Address - City:BARRINGTON
Practice Address - State:RI
Practice Address - Zip Code:02806
Practice Address - Country:US
Practice Address - Phone:401-246-1195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)