Individual
IVAN MASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1500 LAFAYETTE ST STE 125, GRETNA, LA 70053-5758
(504) 209-1906
Mailing address
1500 LAFAYETTE ST STE 125, GRETNA, LA 70053-5758
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
—
—
Other
Enumeration date
06/11/2025
Last updated
06/11/2025
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