Individual provider Active NPI

Tanitsha Keishaun Mason, LCSW

  • Clinical Social Worker
  • Las Vegas, NV
National Provider Identifier
1407099278
Registry record updated Jan 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
5546-C Issued in NV
Practice address
3085 S Jones Blvd Ste D
Las Vegas, NV 89146-6767
Phone
(702) 888-0036
Fax
(702) 888-0035
NPI assigned
Apr 9, 2009
Last updated
Jan 14, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2021

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 5546-C NV Primary

Addresses

Primary practice location

3085 S Jones Blvd Ste D
Las Vegas, NV 89146-6767

Mailing address

3085 S Jones Blvd Ste D
Las Vegas, NV 89146-6767
Phone (702) 888-0036

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20090616000053 NV Practitioner - Clinical Social Worker 8022168905 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3085 S Jones Blvd
Suite D
Las Vegas, NV 89146-6767
Phone (702) 888-0036

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mobile Mental Health Support Services, Inc. Current Accepting new patients
Mobile Mental Health Support Services, Inc. CurrentSince Apr 20, 2009 Accepting new patients
Nevada Improvement Project Past Accepting new patients

Locations

2820 S Jones Blvd
Ste 1
Las Vegas, NV 89146
Phone (702) 556-1511

3085 S Jones Blvd
Ste D
Las Vegas, NV 89146
Phone (702) 888-0036

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1239235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1407099278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3085 S JONES BLVD STE D",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891466767",
            "telephone_number": "702-888-0036",
            "fax_number": "702-888-0035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3085 S JONES BLVD STE D",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891466767",
            "telephone_number": "702-888-0036",
            "fax_number": "702-888-0035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASON",
        "first_name": "TANITSHA",
        "middle_name": "KEISHAUN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-09",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "5546-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.