Doctor Name: | DR. MARK G. ANSEL |
NPI Number: | 1649227992 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D., LCSW |
License Number: | 3115 |
Business Practice Address: | 54-3885a Akoni Pule Highway Kapaau, HI - 967551439 |
Business Phone Number: | 8088845300 |
Business Fax Number: | 8088845300 |
Mailing Address: | Po Box 1469, KAPAAU |
State: | HI |
Postal Code: | 967551439 |
Phone Number: | 8088845300 |
Fax Number: | 8088845300 |
NPI Enumeration Date: | 05/30/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 3115 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | HI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |