Provider Demographics
NPI:1881956274
Name:MASON, THEMBEKA C (PHD)
Entity type:Individual
Prefix:MRS
First Name:THEMBEKA
Middle Name:C
Last Name:MASON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2603 CECIL B MOORE AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19121-2826
Mailing Address - Country:US
Mailing Address - Phone:215-769-7045
Mailing Address - Fax:215-769-7046
Practice Address - Street 1:2603 CECIL B MOORE AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19121-2826
Practice Address - Country:US
Practice Address - Phone:215-769-7045
Practice Address - Fax:215-769-7046
Is Sole Proprietor?:No
Enumeration Date:2012-06-12
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional