Healthcare Provider Details

I. General information

NPI: 1780761742
Provider Name (Legal Business Name): MARK STEVEN CADAVERO MSW, LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 05/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 VALLEY RIVER AVE STE D
MURPHY NC
28906-3000
US

IV. Provider business mailing address

PO BOX 1704
MURPHY NC
28906-8860
US

V. Phone/Fax

Practice location:
  • Phone: 828-837-7529
  • Fax: 828-837-8410
Mailing address:
  • Phone: 828-837-7529
  • Fax: 828-837-8410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC003424
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier6002030
Identifier TypeMEDICAID
Identifier StateNC
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: