Organization Active NPI

Candace Mason LLC

  • Professional Counselor
  • Okemos, MI
National Provider Identifier
1417664012
Registry record updated Dec 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
CANDACE MASON LLC
Practice address
4660 Marsh Rd Ste 21
Okemos, MI 48864-2143
Phone
(517) 295-3351
NPI assigned
Nov 2, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2023

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

Authorized official

Name
Candace Johnson-Mason, MA, LPC-S, NCC, CFRC
Title
Owner/Biller
Phone
(517) 295-3351

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

4660 Marsh Rd Ste 21
Okemos, MI 48864-2143

Mailing address

5815 Bent Tree Dr
East Lansing, MI 48823-7789
Phone (517) 483-2461

Other practice location 1

5815 Bent Tree Dr
East Lansing, MI 48823-7789
Phone (517) 483-2461

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240419001496 MI Part B Supplier - Clinic/Group Practice 7911346234 Receives reassigned benefits from 1 practitioner
Practice locations: Okemos, MI

National Provider Directory

National Provider Directory

Locations

4660 Marsh Rd
Ste 21
Okemos, MI 48864
Phone (517) 295-3351

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1667347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703721600000",
    "number": "1417664012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5815 BENT TREE DR",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488237789",
            "telephone_number": "517-483-2461",
            "fax_number": "517-323-9531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4660 MARSH RD STE 21",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488642143",
            "telephone_number": "517-295-3351"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5815 Bent Tree Dr",
            "address_purpose": "LOCATION",
            "city": "East Lansing",
            "state": "MI",
            "postal_code": "488237789",
            "country_code": "US",
            "telephone_number": "517-483-2461",
            "fax_number": "517-323-9531",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CANDACE MASON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-02",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-28",
        "status": "A",
        "authorized_official_last_name": "JOHNSON-MASON",
        "authorized_official_first_name": "CANDACE",
        "authorized_official_title_or_position": "OWNER/BILLER",
        "authorized_official_telephone_number": "517-295-3351",
        "authorized_official_credential": "MA, LPC-S, NCC, CFRC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Okemos, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.