Provider Demographics
NPI:1912135468
Name:MASON, JULIA ANN (LMHP, LCSW)
Entity Type:Individual
Prefix:MISS
First Name:JULIA
Middle Name:ANN
Last Name:MASON
Suffix:
Gender:F
Credentials:LMHP, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5120 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68104-3555
Mailing Address - Country:US
Mailing Address - Phone:531-299-7974
Mailing Address - Fax:
Practice Address - Street 1:5120 MAPLE ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68104-3555
Practice Address - Country:US
Practice Address - Phone:531-299-7974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-23
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8707101YM0800X
NE6633104100000X
NE42711041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker