DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: MARK MARTIN LCSW

MEDICARE: MARK MARTIN LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker11448098-3501UT

General Provider Information

NPI Number : 1356316392
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK MARTIN LCSW
Provider Business Mailing Address
First Line : 750 N FREEDOM BLVD
Second Line :
City : PROVO
State : UT
Zip : 84601-1677
Country : US
Telephone Number : 801-373-4760
Fax Number : 801-373-0639
Provider Business Practice Location Address
First Line : 750 N FREEDOM BLVD
Second Line :
City : PROVO
State : UT
Zip : 84601-1677
Country : US
Telephone Number : 801-373-4760
Fax Number : 801-373-0639
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2006
Last Update Date : 01/03/2020

Similar Medicare Providers

1477166551 — MACKENZIE IRENE QUINTON
Practice Location Address:
750 N FREEDOM BLVD
PROVO, UT
84601-1677
Practice Phone: 801-373-4760
Practice Fax:
1720714405 — AMY COLTON LMFT
Practice Location Address:
750 N FREEDOM BLVD
PROVO, UT
84601-1677
Practice Phone: 801-373-4760
Practice Fax:
1568059509 — JACINTA TAYLOR CPSS, FPSS, SSW
Practice Location Address:
750 N FREEDOM BLVD
PROVO, UT
84601-1677
Practice Phone: 801-373-4760
Practice Fax: 801-373-0639
1679551634 — MS. AMY BUEHLER LCSW
Practice Location Address:
750 N FREEDOM BLVD
PROVO, UT
84601-1677
Practice Phone: 801-373-4760
Practice Fax: 801-373-0639
1922012251 — JEFFREY MARVIN DALLEY LCSW
Practice Location Address:
750 N FREEDOM BLVD
PROVO, UT
84601-1677
Practice Phone: 801-373-4760
Practice Fax:
1700995909 — MR. MICHAEL TERRY HARTLEY LCSW
Practice Location Address:
750 N FREEDOM BLVD
PROVO, UT
84601-1677
Practice Phone: 801-373-4760
Practice Fax:

Directions to “ MARK MARTIN LCSW” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.