Doctor Name: | MARK CHUOKE |
NPI Number: | 1366848616 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW |
License Number: | 002387 |
Business Practice Address: | 207 Storrs Rd Mansfield Center, CT - 062501638 |
Business Phone Number: | 8604811351 |
Business Fax Number: | |
Mailing Address: | 265 Paine Rd, POMFRET CENTER |
State: | CT |
Postal Code: | 062591928 |
Phone Number: | 8603157654 |
Fax Number: | |
NPI Enumeration Date: | 11/14/2014 |
NPI Last Update Date: | 11/14/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 002387 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |