Provider Demographics
NPI:1063445054
Name:MASON, JANICE LYNN (MSW)
Entity type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:LYNN
Last Name:MASON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 VILES ST
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330-5345
Mailing Address - Country:US
Mailing Address - Phone:207-622-4492
Mailing Address - Fax:
Practice Address - Street 1:3 VILES ST
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-5345
Practice Address - Country:US
Practice Address - Phone:207-622-4492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC39261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical