MEDICARE: MR. MARK A ROBART LICSW

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
1	1041C0700X	Clinical Social Worker	103656	MA

General Provider Information

NPI Number	:	1639169873
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MARK A ROBART LICSW

Provider Business Mailing Address
First Line	:	87 WOLF ROCK RD
Second Line	:
City	:	CARLISLE
State	:	MA
Zip	:	01741-1129
Country	:	US
Telephone Number	:	978-369-0259
Fax Number	:

Provider Business Practice Location Address
First Line	:	87 WOLF ROCK RD
Second Line	:
City	:	CARLISLE
State	:	MA
Zip	:	01741-1129
Country	:	US
Telephone Number	:	978-369-0259
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/27/2005
Last Update Date	:	07/08/2007

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Directions to “ MR. MARK A ROBART LICSW” Practice Location

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