Provider Demographics
NPI:1932801867
Name:MASON, AMY MEAD (LMSW)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:MEAD
Last Name:MASON
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 1:1222 COLUMBIA ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-7012
Mailing Address - Country:US
Mailing Address - Phone:713-882-3712
Mailing Address - Fax:
Practice Address - Street 1:1404 ALLSTON ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-4208
Practice Address - Country:US
Practice Address - Phone:281-940-5538
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-22
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108623104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker