MEDICARE: STEPHANIE MARKS, LICENSED CLINICAL SOCIAL WORKER, A PROFESSIONAL CORPORATION

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

General Provider Information

NPI Number	:	1902764970
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEPHANIE MARKS, LICENSED CLINICAL SOCIAL WORKER, A PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	3711 LONG BEACH BLVD STE 4740
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90807-3315
Country	:	US
Telephone Number	:	562-221-6999
Fax Number	:

Provider Business Practice Location Address
First Line	:	3711 LONG BEACH BLVD STE 4740
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90807-3315
Country	:	US
Telephone Number	:	562-221-6999
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	STEPHANIE MARKS
Credential	:	LCSW
Telephone Number	:	323-236-5081

Provider Enumeration Date	:	01/09/2026
Last Update Date	:	01/09/2026

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