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General NPI Number Information
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NPI Number | 1487275004
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Entity Type | Individual
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Provider Name | MARK ALBERT CASAS LCSW
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Gender | Male
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Dates
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Enumeration Date | 05/05/2020
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Last Update Date | 09/29/2022
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Provider Practice Location Address
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Address Line | 3250 WILSHIRE BLVD FL 3
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City | LOS ANGELES
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State | CA
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Zip | 90010-1577
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Country | US
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Telephone | 323-361-3028
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Fax |
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Provider Business Mailing Address
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Address Line | 4650 W SUNSET BLVD, MAILSTOP #2
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City | LOS ANGELES
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State | CA
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Zip | 90027-4432
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Country | US
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Telephone | 714-623-4244
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 108771
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License Number State | CA
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