Provider Demographics
NPI:1346643244
Name:MASON, VICTORIA (LMFT)
Entity type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:
Last Name:MASON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MS
Other - First Name:VICTORIA
Other - Middle Name:
Other - Last Name:BRODERSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LMFT
Mailing Address - Street 1:625 COURT STREET
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51101-1919
Mailing Address - Country:US
Mailing Address - Phone:712-252-3871
Mailing Address - Fax:712-252-3157
Practice Address - Street 1:625 COURT STREET
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51101-1919
Practice Address - Country:US
Practice Address - Phone:712-252-3871
Practice Address - Fax:712-252-3157
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-06
Last Update Date:2022-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0915931041C0700X, 106H00000X
NC1771106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical