Provider Demographics
NPI:1215249305
Name:MASON, PATRICIA ANN (MA)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANN
Last Name:MASON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:ANN
Other - Last Name:WHINERY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1668 BIRCHFIELD RD
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73012-2391
Mailing Address - Country:US
Mailing Address - Phone:405-509-1050
Mailing Address - Fax:
Practice Address - Street 1:6023 NW 120TH CT
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73162-1790
Practice Address - Country:US
Practice Address - Phone:405-509-1050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-06
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
OK1051101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health