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Organization
JOAN S MASON LCSW CAP P A
Active
Organization
JOAN S MASON LCSW CAP P A
Active
Other names
Chrysalis Center
Organization subpart
No
Provider details
NPI number
Authorized official
JOAN S MASON LCSW (OWNER)
(727) 743-9060
Entity
Organization
Contact information
Practice address
3321 49TH ST N, ST PETERSBURG, FL 33710-2145
(727) 743-9060
(727) 367-4139
Mailing address
200 1ST AVE, #305, ST PETE BEACH, FL 33706-4364
(727) 744-4880
(727) 367-4139
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW4600
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0739204
CIGNA
FL
01
—
1538207667
MEDICARE PROVIDER ID 1538207667
FL
01
—
182234000
MAGELLAN
FL
01
—
4014110
HUMANA
FL
01
—
512778450
UNITED BEHAVIORAL HEALTH
—
01
—
7940163
AETNA
FL
01
—
AK104
MEDICARE GROUP PTAN
FL
01
—
P4510
MEDICARE SENDER/SUBMITTER
FL
01
—
Z8210Z
MEDICARE PTAN
FL
Enumeration date
02/01/2007
Last updated
11/16/2012
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