Provider Demographics
NPI:1619799533
Name:MASON, RACHAEL (LISW-CP-S)
Entity type:Individual
Prefix:
First Name:RACHAEL
Middle Name:
Last Name:MASON
Suffix:
Gender:F
Credentials:LISW-CP-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 PERRY RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29609-3528
Mailing Address - Country:US
Mailing Address - Phone:740-272-6684
Mailing Address - Fax:
Practice Address - Street 1:616 PERRY RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29609-3528
Practice Address - Country:US
Practice Address - Phone:740-272-6684
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-30
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC133491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical