Deetra Michelle Mason

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

202 W Park Ave
Champaign, IL 61820-3929

Phone

(217) 373-2436

Fax

(217) 373-2444

NPI assigned

Sep 13, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1189641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189641600000",
    "number": "1972798890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 W PARK AVE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618203929",
            "telephone_number": "217-373-2436",
            "fax_number": "217-373-2444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 W PARK AVE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618203929",
            "telephone_number": "217-373-2436",
            "fax_number": "217-373-2444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASON",
        "first_name": "DEETRA",
        "middle_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-13",
        "last_updated": "2007-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suzanne Martinez, LMFT
• Eva G Martone, MSW
• Susan Masareth
• Ellie Masengale, LSW
• Dynesha Dione Mason-Grissom, PH.D.
• Katelyn Mason
• Rachel Mateyka
• Wendy Mathewson, LPC
• Rachel McCullough Matthews, D.MIN., LPC, LCPC
• Venu Maturi, DDS

• Counselor in Champaign, IL
• Providers in Champaign, IL by specialty
• Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2007; 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.