Bragg, Mark W

Bragg, Mark W is an sole proprietor health care provider with primary practice located at 4209 John Silver Rd , Virginia Beach VA 23455-2131. He recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as his primary health care specialty. Bragg, Mark W can be contacted via phone (757) 363-2825.

Contact Information

Primary practice address
4209 John Silver Rd Virginia Beach VA 23455-2131
Fax: (757) 363-2825
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 0701003261 Virginia

Profile Details

NPI number 1831249523
LBN Legal business name Bragg, Mark W
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 12th, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831249523 NPPES
Virginia Other 0701003261 LICENSE NUMBER

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