O'Dell, Mark P

O'Dell, Mark P is an individual health care provider with primary practice located at 1190 W Roosevelt Blvd , Monroe NC 28110-2818. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. O'Dell, Mark P can be contacted via phone (704) 296-6200.

Contact Information

Primary practice address
1190 W Roosevelt Blvd Monroe NC 28110-2818
Phone: (704) 296-6200
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X C005296 North Carolina
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X
Behavioral Health & Social Service Providers / Clinical 1041C0700X

Profile Details

NPI number 1720260102
LBN Legal business name O'Dell, Mark P
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 28th, 2007
Last updated Jan 3rd, 2008 - about 16 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 1720260102 NPPES
North Carolina MEDICAID 6106809
North Carolina Other 147NF

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