Masterson Psychotherapy, LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

0904006823 Issued in VA

Legal business name

MASTERSON PSYCHOTHERAPY, LLC

Practice address

4445 Corporation LN Ste 213
Virginia Beach, VA 23462-3262

Phone

(757) 237-2906

Fax

(757) 216-9655

NPI assigned

Aug 21, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Susan Masterson, LCSWNPI 1851552491

Title

Owner

Phone

(757) 237-2906

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Susan Elizabeth Masterson, LCSW

  • Social Worker
  • Virginia Beach, VA
  • NPI 1851552491
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1534809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713830400000",
    "number": "1013498757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4445 CORPORATION LN STE 213",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234623262",
            "telephone_number": "757-237-2906",
            "fax_number": "757-216-9655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4445 CORPORATION LN STE 213",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234623262",
            "telephone_number": "757-237-2906",
            "fax_number": "757-216-9655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASTERSON PSYCHOTHERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-21",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A",
        "authorized_official_last_name": "MASTERSON",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "757-237-2906",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "VA",
            "license": "0904006823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1851552491",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kerri Mast
• Mose Mast
• Master Plan Therapy, LLC
• Kristin Master, LPC
• Paryn Rae Masters
• Susan Elizabeth Masterson, LCSW
• Elizabeth Marie Matamoros-Flora
• Makenzie Harman Mathers, FNP-C
• Stacey Renee Mathes, PHARM. D.
• Matty Matheson, DPT

• Adult Mental Health Clinic/Center in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Adult Mental Health Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.