| Candace Mason Llc | |
|
4660 Marsh Rd Ste 21 Okemos MI 48864-2143 | |
| (517) 295-3351 | |
| Not Available |
| Full Name | Candace Mason Llc |
|---|---|
| Speciality | Counselor |
| Location | 4660 Marsh Rd Ste 21, Okemos, Michigan |
| Authorized Official Name and Position | Candace Johnson-mason (OWNER/BILLER) |
| Authorized Official Contact | 5172953351 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Candace Mason Llc 5815 Bent Tree Dr East Lansing MI 48823-7789 Ph: (517) 483-2461 | Candace Mason Llc 4660 Marsh Rd Ste 21 Okemos MI 48864-2143 Ph: (517) 295-3351 |
| NPI Number | 1417664012 |
|---|---|
| Provider Enumeration Date | 11/02/2022 |
| Last Update Date | 12/28/2023 |
| Certification Date | 12/28/2023 |
| Medicare PECOS PAC ID | 7911346234 |
|---|---|
| Medicare Enrollment ID | O20240419001496 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417664012 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Candace Mason |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1962754408 PECOS PAC ID: 2769822576 Enrollment ID: I20240419001449 |
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