Individual provider Active NPI

Candace Lee Mason, MA, LPC-S, NCC, CFRC

  • Professional Counselor
  • Okemos, MI
National Provider Identifier
1962754408
Registry record updated Apr 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401013260 Issued in MI
Practice address
4460 Okemos Rd Ste 21
Okemos, MI 48864-2553
Phone
(517) 974-2402
NPI assigned
Oct 8, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6401013260 MI Primary

Addresses

Primary practice location

4460 Okemos Rd Ste 21
Okemos, MI 48864-2553

Mailing address

5815 Bent Tree Dr
East Lansing, MI 48823-7789
Phone (517) 974-2402

Other practice location 1

5815 Bent Tree Dr
East Lansing, MI 48823-7789
Phone (517) 974-2402

Other names 1

  • Candace Lee Johnson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20240419001449 MI Practitioner - Mental Health Counselor 2769822576 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Candace Mason LLC Professional CurrentSince Mar 9, 2024 Accepting new patients
Oakland Psychological Clinic, P.C. PastSince Jan 26, 2022 Accepting new patients
Jonathan M. Blair PHD, PLLC Past Accepting new patients

Locations

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

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": "1349654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713484800000",
    "number": "1962754408",
    "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": "517-974-2402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4460 OKEMOS RD STE 21",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488642553",
            "telephone_number": "517-974-2402"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5815 Bent Tree Dr",
            "address_purpose": "LOCATION",
            "city": "East Lansing",
            "state": "MI",
            "postal_code": "488237789",
            "country_code": "US",
            "telephone_number": "517-974-2402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASON",
        "first_name": "CANDACE",
        "middle_name": "LEE",
        "credential": "MA, LPC-S, NCC, CFRC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-08",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401013260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CANDACE",
            "last_name": "JOHNSON",
            "middle_name": "LEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Okemos, MI

Sources for this page

Verify at the official NPI Registry.