Prorok, Alexander Mark
Prorok, Alexander Mark is an sole proprietor health care provider with primary practice located at 3670 County Road 4990 , Willow Springs MO 65793-0506. He recently has 5 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Agencies / Day Training, Developmentally Disabled Services, Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities, Respite Care Facility / Respite Care, Nursing Service Related Providers / Personal Care Attendant. Behavioral Health & Social Service Providers / Mental Health is his primary health care specialty. Prorok, Alexander Mark can be contacted via phone (417) 469-2951.Contact Information
Primary practice address
3670 County Road 4990
Willow Springs MO 65793-0506
Phone: (417) 469-2951
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 2002032260 | Missouri |
| Agencies / Day Training, Developmentally Disabled Services | 251C00000X | 2002032260 | Missouri |
| Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 320900000X | 2002032260 | Missouri |
| Respite Care Facility / Respite Care | 385H00000X | 2002032260 | Missouri |
| Nursing Service Related Providers / Personal Care Attendant | 3747P1801X | 2002032260 | Missouri |
Profile Details
| NPI number | 1598742777 |
|---|---|
| LBN Legal business name | Prorok, Alexander Mark |
| Credentials | Licensed Professional Counselor (LPC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 28th, 2005 |
| Last updated | Aug 26th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1598742777 | NPPES |
| Missouri | MEDICAID | 498342609 | |
| Missouri | MEDICAID | 858342603 |
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