Martello, Mark Allen

Martello, Mark Allen is an individual health care provider with primary practice located at 325 E H St , Iron Mountain MI 49801-4760. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Martello, Mark Allen can be contacted via phone (906) 774-3300.

Contact Information

Primary practice address
325 E H St Iron Mountain MI 49801-4760
Phone: (906) 774-3300
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 8830-123 Wisconsin
Behavioral Health & Social Service Providers / Clinical 1041C0700X LCSW-1205 Idaho

Profile Details

NPI number 1629068622
LBN Legal business name Martello, Mark Allen
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 21st, 2005
Last updated Sep 10th, 2019 - about 5 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 1629068622 NPPES
Idaho Other LCSW-1205 STATE LICENSE

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