Provider Demographics
NPI:1144371899
Name:MASON-REESE, CHARLENE W (LCSW)
Entity type:Individual
Prefix:MS
First Name:CHARLENE
Middle Name:W
Last Name:MASON-REESE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 NEWFIELD ST
Mailing Address - Street 2:#2
Mailing Address - City:EAST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07017-5410
Mailing Address - Country:US
Mailing Address - Phone:201-725-1807
Mailing Address - Fax:908-820-4290
Practice Address - Street 1:31 NEWFIELD ST
Practice Address - Street 2:#2
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07017-5410
Practice Address - Country:US
Practice Address - Phone:201-725-1807
Practice Address - Fax:908-820-4290
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC005868001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical