Mark W Underwood, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

35001750A. Issued in IN

Practice address

5150 E Stop 11 Rd
Ste 14
Indianapolis, IN 46237-8628

Phone

(317) 200-1567

NPI assigned

Sep 5, 2012

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1346803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489795200000",
    "number": "1093064016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8810 LATITUDES DR",
            "address_2": "APT 802",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462378390",
            "telephone_number": "251-200-1567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5150 E STOP 11 RD",
            "address_2": "STE 14",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462378628",
            "telephone_number": "317-200-1567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNDERWOOD",
        "first_name": "MARK",
        "middle_name": "W",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-09-05",
        "last_updated": "2017-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IN",
            "license": "35001750A.",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "AL",
            "license": "437",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Marriage & Family Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.