Mast, Kathleen Renee
Mast, Kathleen Renee is an individual health care provider with primary practice located at 113 Lincolnway E , Mishawaka IN 46544-2016. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Mast, Kathleen Renee can be contacted via phone (574) 255-4976.Contact Information
Primary practice address
113 Lincolnway E
Mishawaka IN 46544-2016
Phone: (574) 255-4976
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 34001414A | Indiana |
Profile Details
| NPI number | 1275501355 |
|---|---|
| LBN Legal business name | Mast, Kathleen Renee |
| Credentials | MSW, LCSW |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 14th, 2006 |
| Last updated | Jan 22nd, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1275501355 | NPPES |
| Indiana | Other | 000000391927 | ANTHEM BCBS # |
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