Individual
JORDAN LUCUS MASTERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
353 E 8TH ST, MOUNTAIN HOME, AR 72653-4423
(870) 701-5141
(870) 701-5177
Mailing address
PO BOX 299, HOXIE, AR 72433-0299
(870) 886-1333
(870) 886-1334
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
9677-M
AR
1041C0700X
Clinical Social Worker
Primary
9677-C
AR
Other
Enumeration date
10/01/2019
Last updated
06/18/2024
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