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NPI Code Detail

MEDICARE: MR. MARK A YODER MA ED, LPCC

MEDICARE: MR. MARK A YODER MA ED, LPCC
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
1101YM0800XMental Health CounselorE3540OH
2101YM0800XMental Health CounselorE0003540OH

General Provider Information

NPI Number : 1184763146
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MARK A YODER MA ED, LPCC
Provider Business Mailing Address
First Line : 2587 BACK ORRVILLE RD
Second Line :
City : WOOSTER
State : OH
Zip : 44691-9523
Country : US
Telephone Number : 330-264-9597
Fax Number : 330-264-0946
Provider Business Practice Location Address
First Line : 2587 BACK ORRVILLE RD
Second Line :
City : WOOSTER
State : OH
Zip : 44691-9523
Country : US
Telephone Number : 330-264-9597
Fax Number : 330-264-0946
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2007
Last Update Date : 11/14/2013

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