Provider Demographics
NPI:1720825227
Name:JENNIFER MASON, MED, LPC, PLLC
Entity type:Organization
Organization Name:JENNIFER MASON, MED, LPC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER AND SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MASON
Authorized Official - Suffix:
Authorized Official - Credentials:MED, LPC-S
Authorized Official - Phone:806-544-2615
Mailing Address - Street 1:100 OAK BEND TRL
Mailing Address - Street 2:
Mailing Address - City:LIPAN
Mailing Address - State:TX
Mailing Address - Zip Code:76462-4520
Mailing Address - Country:US
Mailing Address - Phone:806-544-2615
Mailing Address - Fax:432-200-1882
Practice Address - Street 1:203 W WALL ST STE 324
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-4509
Practice Address - Country:US
Practice Address - Phone:432-302-6338
Practice Address - Fax:432-200-1882
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JENNIFER MASON, MED, LPC, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-07-11
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty