Toni L Mason, PH.D.

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

2674 Issued in GA

Practice address

1361 Jennings Mill Rd
Suite 201
Bogart, GA 30622-2579

Phone

(706) 316-1908

Fax

(706) 316-2062

NPI assigned

Nov 14, 2006

Last updated

Sep 20, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Athens Behavioral Medicine

  • Psychiatry Physician
  • Bogart, GA
  • NPI 1902026347
  NPD (past)

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190246400000",
    "number": "1043382021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1361 JENNINGS MILL RD",
            "address_2": "SUITE 201",
            "city": "BOGART",
            "state": "GA",
            "postal_code": "306222579",
            "telephone_number": "706-316-1908",
            "fax_number": "706-316-2062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1361 JENNINGS MILL RD",
            "address_2": "SUITE 201",
            "city": "BOGART",
            "state": "GA",
            "postal_code": "306222579",
            "telephone_number": "706-316-1908",
            "fax_number": "706-316-2062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASON",
        "first_name": "TONI",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2007-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "2674",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "GA",
            "license": "2674",
            "primary": true
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "GA",
            "license": "2674",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "10034544",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marie Joyce Herrera Manaog
• Lydia Marchant
• Mark a Ellis, MD, PC
• Janet Stillman Martin, PH.D.
• Sam Luke Martin, PHARMD
• Van Scott McCorkle, MD
• Thomas W McCormack Jr., MD
• Tymichia McGill
• Virginia McKenna, M.ED.
• Megan Milian

• Clinical Child & Adolescent Psychologist in Bogart, GA
• Providers in Bogart, GA by specialty
• Clinical Child & Adolescent Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.