Provider Demographics
NPI:1750553194
Name:MASON, CHRISTINE ELIZABETH (PSYD, LP)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:ELIZABETH
Last Name:MASON
Suffix:
Gender:F
Credentials:PSYD, LP
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:MASON
Other - Last Name:NAVRAT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSY D, LP
Mailing Address - Street 1:1900 CENTRA CARE CIRCLE #2475
Mailing Address - Street 2:CENTRA CARE HEALTH PLAZA
Mailing Address - City:ST. CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303
Mailing Address - Country:US
Mailing Address - Phone:320-229-5199
Mailing Address - Fax:320-229-5109
Practice Address - Street 1:1406 6TH AVENUE NORTH
Practice Address - Street 2:ST. CLOUD HOSPITAL
Practice Address - City:ST. CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-1901
Practice Address - Country:US
Practice Address - Phone:320-251-2700
Practice Address - Fax:320-229-5109
Is Sole Proprietor?:No
Enumeration Date:2008-03-26
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017436103TC0700X
MNLO5030103TC0700X
MNLP5030103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical