Mask Off Therapeutic PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

MASK OFF THERAPEUTIC PLLC

Practice address

8501 Tower Point Dr
Charlotte, NC 28227-7849

Phone

(203) 530-0245

NPI assigned

Mar 25, 2020

Organization subpart

No

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

Authorized official

Name

Keba Saban Bosley, MSW LCSWNPI 1649726589

Title

Ceo

Phone

(203) 530-0245

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Practitioners 1

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

• Keba Bosley

  • Clinical Social Worker
  • Mint Hill, NC
  • NPI 1649726589
  NPD Authorized official

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

{
    "created_epoch": "1585094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585094400000",
    "number": "1104453547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5912 BRIGHTSTAR VALLEY RD",
            "city": "MINT HILL",
            "state": "NC",
            "postal_code": "282277691",
            "telephone_number": "203-530-0245",
            "fax_number": "704-910-3057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8501 TOWER POINT DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282277849",
            "telephone_number": "203-530-0245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASK OFF THERAPEUTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-25",
        "last_updated": "2020-03-25",
        "certification_date": "2020-03-25",
        "status": "A",
        "authorized_official_last_name": "BOSLEY",
        "authorized_official_first_name": "KEBA",
        "authorized_official_middle_name": "SABAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "203-530-0245",
        "authorized_official_credential": "MSW LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1041C0700X",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "kbosley@maskofftherapeeuticservice.com",
            "affiliation": "N",
            "address_1": "8501 Tower Point Dr",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282277849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nicholas Joseph Masciello, DO
• Kathryn Maselli
• Isabella Masese, NP
• Elizabeth Mashburn, M. ED
• Michael Masi, DPT
• Lisa Wohlbruck Mask, LPC,NCC,RN
• Douglas Joseph Maslowski
• Mason & Mincey OD PA
• Benita J. Mason, NC CERTIFIED PEER SU
• Caitlin Elizabeth Mason, RBT

• Clinical Social Worker in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2020; 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.