Individual
MASON CARPENTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW, LICSW
Contact information
Practice address
15265 CARROUSEL WAY, ROSEMOUNT, MN 55068-1760
(651) 374-1423
Mailing address
15265 CARROUSEL WAY, ROSEMOUNT, MN 55068-1760
(651) 374-1423
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
29105
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
05/22/2023
Last updated
08/07/2024
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