Individual provider Active NPI

Sharon Mason, M.A. L.P.

  • Psychologist
  • Roseville, MN
National Provider Identifier
1962513713
Registry record updated Jan 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
LP3070 Issued in MN
Practice address
2720 Fairview Ave N Ste 100
Roseville, MN 55113-1306
Phone
(651) 241-5290
Fax
(651) 241-5140
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X LP3070 MN Primary

Addresses

Primary practice location

2720 Fairview Ave N Ste 100
Roseville, MN 55113-1306

Mailing address

2720 Fairview Ave N Ste 100
Roseville, MN 55113-1306
Phone (651) 241-5290

Other identifiers 1

IdentifierTypeStateIssuer
670715700MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20240715001404 MN Practitioner - Mental Health Counselor 7719422799 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3070MNMDProfessional Counselor
LP3070MNMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Minnesota Renewal Center Psychologist CurrentSince May 1, 2024 Accepting new patients
Cook Counseling Services, LLC CurrentSince May 1, 2024 Accepting new patients
Minnesota Epilepsy Group PA CurrentSince Jan 26, 2022 Accepting new patients

Locations

1711 County Road B W
Ste 200S
Roseville, MN 55113
Phone (651) 486-4828

225 Smith Ave N
Ste 201
Saint Paul, MN 55102
Phone (651) 241-5290

2720 Fairview Ave N
#100
Saint Paul, MN 55113
Phone (651) 241-5290

3499 Lexington Ave N
Ste 100
Saint Paul, MN 55126
Phone (651) 317-3723

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EFDABA

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1962513713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2720 FAIRVIEW AVE N STE 100",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551131306",
            "telephone_number": "651-241-5290",
            "fax_number": "651-241-5140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 FAIRVIEW AVE N STE 100",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551131306",
            "telephone_number": "651-241-5290",
            "fax_number": "651-241-5140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASON",
        "first_name": "SHARON",
        "credential": "M.A.  L.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP3070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "670715700",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, MN

Sources for this page

Verify at the official NPI Registry.