Provider Demographics
NPI:1881113801
Name:CEASAR, MASON D (BA)
Entity type:Individual
Prefix:
First Name:MASON
Middle Name:D
Last Name:CEASAR
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12097 OLD HAMMOND HWY STE I1
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-8679
Mailing Address - Country:US
Mailing Address - Phone:225-421-1881
Mailing Address - Fax:225-421-1882
Practice Address - Street 1:1520 THOMAS H DELPIT DR STE 219
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70802
Practice Address - Country:US
Practice Address - Phone:225-389-0138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health