Organization Name: | MARK MODLIN, INC. |
NPI Number: | 1881003705 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARK ALAN MODLIN (OWNER) |
Mailing Address: | 130 Dudley Pike Suite 120 Edgewood |
State: | KY US |
Postal Code: | 410172396 |
Phone Number: | 8593417170 |
Fax Number: | 8593417173 |
NPI Enumeration Date: | 08/05/2014 |
NPI Last Update Date: | 08/05/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | C.0001640 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |