Provider Demographics
NPI:1649542267
Name:MASON, KATIE (MA, NCC)
Entity type:Individual
Prefix:MS
First Name:KATIE
Middle Name:
Last Name:MASON
Suffix:
Gender:F
Credentials:MA, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2150 W 29TH AVE
Mailing Address - Street 2:SUITE 125
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-3844
Mailing Address - Country:US
Mailing Address - Phone:303-587-3726
Mailing Address - Fax:
Practice Address - Street 1:2150 W 29TH AVE
Practice Address - Street 2:SUITE 125
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-3844
Practice Address - Country:US
Practice Address - Phone:303-587-3726
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-27
Last Update Date:2012-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO11508101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health