Provider Demographics
NPI:1932555901
Name:MASTON, KATHLEEN MICHELE (LMSW)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:MICHELE
Last Name:MASTON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7809 AIRLINE DR STE 209
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70003-6440
Mailing Address - Country:US
Mailing Address - Phone:504-331-8935
Mailing Address - Fax:504-516-2197
Practice Address - Street 1:7809 AIRLINE DR STE 209
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70003-6440
Practice Address - Country:US
Practice Address - Phone:504-516-2162
Practice Address - Fax:504-516-2197
Is Sole Proprietor?:No
Enumeration Date:2016-05-10
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10033104100000X, 171M00000X
LA103229163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health