Individual provider Active NPI

Chuck L Mason, BS

  • Mental Health Counselor
  • Charleston, IL
National Provider Identifier
1417694498
Registry record updated Jun 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1836 Victoria LN
Charleston, IL 61920-2964
Phone
(217) 508-8080
Fax
(217) 512-2288
NPI assigned
May 19, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X IL Primary

Addresses

Primary practice location

1836 Victoria LN
Charleston, IL 61920-2964

Mailing address

1836 Victoria LN
Charleston, IL 61920-2964
Phone (217) 508-8080

Other practice location 1

735 18th St
Charleston, IL 61920-2383
Phone (217) 508-8080

Other names 1

  • Charles L Mason Professional name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL TherapyNotes Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Neuro Harmony PLLC CurrentSince May 22, 2022 Accepting new patients
Rankin Forensics, LLC PastSince Apr 17, 2022 Accepting new patients

Locations

735 18th St
Charleston, IL 61920
Phone (217) 345-6582

1836 Victoria Ln
Charleston, IL 61920
Phone (217) 508-7953

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1652918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1417694498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1836 VICTORIA LN",
            "city": "CHARLESTON",
            "state": "IL",
            "postal_code": "619202964",
            "telephone_number": "217-508-8080",
            "fax_number": "217-512-2288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1836 VICTORIA LN",
            "city": "CHARLESTON",
            "state": "IL",
            "postal_code": "619202964",
            "telephone_number": "217-508-8080",
            "fax_number": "217-512-2288"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "735 18th St",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "IL",
            "postal_code": "619202383",
            "country_code": "US",
            "telephone_number": "217-508-8080",
            "fax_number": "217-512-2288",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASON",
        "first_name": "CHUCK",
        "middle_name": "L",
        "credential": "BS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-19",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "TherapyNotes",
            "affiliation": "N",
            "endpointDescription": "Annex",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1836 Victoria Ln",
            "city": "Charleston",
            "state": "IL",
            "country_code": "US",
            "postal_code": "619202964",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CHARLES",
            "last_name": "MASON",
            "middle_name": "L",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Charleston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2022; 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.