Matthew Clark Mason, LADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

101YA0400X Issued in MN

Practice address

7801 E Bush Lake Rd
Edina, MN 55439-3120

Phone

(952) 479-4261

NPI assigned

Dec 9, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• LTC Professionals, PLLC

  • Internal Medicine Physician
  • Bloomington, MN
  • NPI 1417251935

  Single Specialty

  NPD

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

{
    "created_epoch": "1733702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1235945791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7801 E BUSH LAKE RD STE 400",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554393113",
            "telephone_number": "612-481-9063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7801 E BUSH LAKE RD",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554393120",
            "telephone_number": "952-479-4261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASON",
        "first_name": "MATTHEW",
        "middle_name": "CLARK",
        "credential": "LADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-12-09",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "101YA0400X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin B Marty, DC
• Susan Martyeldridge, D.C.
• Mary Mullenbach, PHD, LP, Inc
• Angela N Mason, DO
• Carol A Mason, D.D.S.
• Mohamed Sekou Massallay
• Jessica Lee Massie
• Michael Joel Mastous, PA-C
• Brayden M Mateuszczyk, PT, DPT
• Curtis Elmer Mathsen, CRNA

• Addiction (Substance Use Disorder) Counselor in Edina, MN
• Providers in Edina, MN by specialty
• Addiction (Substance Use Disorder) Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; 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.