MR. DERRICK A MASON (NPI# 1780901983) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780901983 |
| Entity Type | Individual |
| Full Name | MR. DERRICK A MASON |
| Credential | LMFT |
| Practice Address |
1048 Ashley St Ste 201 Bowling Green KY 42103-2449 |
| Practice Telephone | 2709046567 |
| Mailing Telephone | (270) 904-6567 |
| Enumeration Date | 2010-04-27 |
| Last Update Date | 2018-03-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | 106719 | KY | Behavioral Health & Social Service Providers |
| N | 106H00000X | Marriage & Family Therapist | 09-013 | KY | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1011 Lehman Ave, Suite 103, Bowling Green, KY 421036515 | 2703939833 | 2703939835 |
| 1960 Louisville Rd Ste A, Bowling Green, KY 421011254 | 2709044088 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295239291 | Derrick L Mason | Social Worker | 605 Oriole Pl Sw, Warren, OH 44485-3638 | 2018-03-23 |
| 1669807400 | Derrick Mason Jr. | Kinesiotherapist | 7400 Merton Minter St, San Antonio, TX 78229-4404 | 2013-09-12 |
| Street Address |
1048 ASHLEY ST STE 201 |
| City | BOWLING GREEN |
| State | KY |
| Zip Code | 42103-2449 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033529813 | Derrick Wagoner | Counselor | 1048 Ashley St Ste 201, Bowling Green, KY 42103-2449 | 2014-05-02 |
| 1861802670 | Alysha Ferguson | Social Worker | 1048 Ashley St Ste 201, Bowling Green, KY 42103-2449 | 2014-05-01 |
| 1184034985 | Melynda Amorim | Social Worker | 1048 Ashley St Ste 201, Bowling Green, KY 42103-2449 | 2014-05-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679127781 | Kw Consulting, LLC | Counselor | 1054 Searcy Way, Suite E, Bowling Green, KY 42103 | 2019-07-26 |
| 1063999662 | Southern Kentucky Surgicenter, LLC | Clinic/Center | 484 Golden Autumn Way, Suite 100, Bowling Green, KY 42103 | 2018-07-26 |
| 1780170936 | Midsouth Psychological Services, LLC | Psychologist | 996 Wilkinson Trce Ste A8, Bowling Green, KY 42103 | 2018-07-10 |
| 1760976146 | Prorehab Inc | Clinic/Center | 1110 Wilkinson Trce Ste 101, Bowling Green, KY 42103 | 2018-06-19 |
| 1063927671 | James Toney | Counselor | 624 Eastwood St, Bowling Green, KY 42103 | 2017-12-05 |
| 1366979528 | Laura Elizabeth Compton | Optometrist | 335 New Towne Drive, Bowling Green, KY 42103 | 2017-05-18 |
| 1033562632 | Elizabette Raby | Massage Therapist | 427 Us-31 Bypass, Suite 203, Bowling Green, KY 42103 | 2016-07-19 |
| 1831572460 | Casey Edward Travelsted | Dentist | 940 Us 31 W Bypass, Bowling Green, KY 42103 | 2015-07-01 |
| 1821435074 | Robert Louis Skaggs II | Dermatology | 1818 Wallace Court, Suite 301, Bowling Green, KY 42103 | 2013-05-29 |
| 1770893257 | Michelle Howell | Health Educator | 261 Moats Lane, Bowling Green, KY 42103 | 2010-10-18 |
| Find all providers in zip 42103 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295208577 | Jennifer Kehrle | Marriage & Family Therapist | 119 S 12th St Apt E, Bowling Green, MO 63334-1978 | 2019-01-09 |
| 1336307487 | Charles R Burgett | Marriage & Family Therapist | 410 E 11th Ave, Bowling Green, KY 42101-2637 | 2008-05-27 |
| 1801099031 | Wanda Hale Schubarth | Marriage & Family Therapist | 410 East 11th Street, Bowling Green, KY 42102 | 2007-06-06 |
| 1033246350 | Kimberly G Early | Marriage & Family Therapist | 1830 Destiny Court, Suite 107, Bowling Green, KY 42104 | 2007-02-27 |
| 1245396738 | Diana Gail Caillouet | Marriage & Family Therapist | 2530 Scottsville Rd, 22, Bowling Green, KY 42104-6509 | 2006-12-29 |
| 1295821205 | Full Life Counseling Service, Psc | Marriage & Family Therapist | 1058 Us 31w Byp, Bowling Green, KY 42101-2418 | 2006-10-05 |
| 1295831436 | Tonya L Gregory | Marriage & Family Therapist | 1011 Lehman Ave Ste 103, Bowling Green, KY 42103-6515 | 2006-09-15 |
| 1558471110 | Teresa Rohman | Marriage & Family Therapist | 1719 Ashley Cir Ste 100, Bowling Green, KY 42104-5837 | 2006-08-30 |
| 1235695461 | Steven Allen Tyree | Marriage & Family Therapist | 1911b Scottsville Rd, Bowling Green, KY 42104-3303 | 2019-02-12 |
| 1154802437 | David E. Scott | Marriage & Family Therapist | 1910 Lyda Ave, Bowling Green, KY 42104-3326 | 2018-08-24 |
| Find all providers in BOWLING GREEN | ||||
| City | BOWLING GREEN |
| Zip Code | 42103 |
Please comment or provide details below to improve the information on MR. DERRICK A MASON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.