Individual
MASON ALEXANDER KINGHORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
6155 S GRAND BLVD, SAINT LOUIS, MO 63111-2319
(314) 652-0100
Mailing address
6155 S GRAND BLVD, SAINT LOUIS, MO 63111-2319
(314) 652-0100
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2017005573
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2019037258
LCSW
MO
Enumeration date
07/02/2019
Last updated
04/28/2026
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