Active NPI
Melynda J Mason, LPCC
- Professional Counselor
- Louisville, KY
National Provider Identifier
1073779922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 103626
- Practice address
- 101 W Muhammad Ali Blvd
Louisville, KY 40202-1423 - Phone
- (502) 589-8615
- NPI assigned
- Jul 31, 2008
- Last updated
- Jun 3, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 103626 | KY | Primary |
Addresses
Primary practice location
101 W Muhammad Ali Blvd
Louisville, KY 40202-1423
Mailing address
101 W Muhammad Ali Blvd
Louisville, KY 40202-1423
Phone (502) 589-8615
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790731081 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 103626 | KY | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1464912000000",
"number": "1073779922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 W MUHAMMAD ALI BLVD",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402021423",
"telephone_number": "502-589-8615"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 W MUHAMMAD ALI BLVD",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402021423",
"telephone_number": "502-589-8615"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASON",
"first_name": "MELYNDA",
"middle_name": "J",
"name_prefix": "Miss",
"credential": "LPCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-07-31",
"last_updated": "2016-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "KY",
"license": "103626",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1790731081",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.