Individual provider Active NPI

Patricia Ann Mason, LCSW

  • Clinical Social Worker
  • Ogden, UT
National Provider Identifier
1376633701
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1417093501 LCSW Issued in UT
Practice address
707 24TH St
Suite C
Ogden, UT 84401-2580
Phone
(801) 394-4522
Fax
(801) 394-4555
NPI assigned
Oct 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1417093501 LCSW UT Primary

Addresses

Primary practice location

707 24TH St
Suite C
Ogden, UT 84401-2580

Mailing address

707 24TH St
Suite C
Ogden, UT 84401-2580
Phone (801) 394-4522

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050810000371 UT Practitioner - Clinical Social Worker 3072542059 Practice locations: Ogden, UT

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1417093501 LCSWUTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1160784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376633701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 24TH ST",
            "address_2": "SUITE C",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844012580",
            "telephone_number": "801-394-4522",
            "fax_number": "801-394-4555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 24TH ST",
            "address_2": "SUITE C",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844012580",
            "telephone_number": "801-394-4522",
            "fax_number": "801-394-4555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASON",
        "first_name": "PATRICIA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "1417093501 LCSW",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

Verify at the official NPI Registry.