Provider Demographics
NPI:1306590955
Name:MASON, HANNAH GRACE ALICE (LCSW)
Entity type:Individual
Prefix:MS
First Name:HANNAH
Middle Name:GRACE ALICE
Last Name:MASON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8100 THREE CHOPT ROAD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23229
Mailing Address - Country:US
Mailing Address - Phone:804-354-1881
Mailing Address - Fax:
Practice Address - Street 1:8100 THREE CHOPT ROAD
Practice Address - Street 2:SUITE 101
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23229
Practice Address - Country:US
Practice Address - Phone:804-354-1881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-11
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1366859050101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0904013454OtherBOARD OF SOCIAL WORK DEPARTMENT OF HEALTH PROFESSIONS