David Charles Mack, LICSW(MA), LCSW(AZ)

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW-14109 Issued in AZ

Practice address

7214 E Camino Vecino
Tucson, AZ 85715-3416

Phone

(781) 696-3711

NPI assigned

Nov 28, 2006

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)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Northeast Behavioral Health Corporation

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Beverly, MA
  • NPI 1154302586
  NPD (past)

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428883200000",
    "number": "1346316700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7214 E CAMINO VECINO",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857153416",
            "telephone_number": "781-696-3711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7214 E CAMINO VECINO",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857153416",
            "telephone_number": "781-696-3711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "DAVID",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "LICSW(MA), LCSW(AZ)",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2015-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "111748",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-14109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecka Macias
• Nohemi Maciel, LCSW
• James E Maciulla, MD
• Annika Simone Mack, DNP, FNP-BC
• Curtis F Mack, M.D.
• Deborah Lorraine Mack, LCSW
• Jeffrey T. Mack, M.D.
• Lamar Dion Mack, MBA
• Shirley A. Mack
• Alexandra L Mackay, DPT

• Clinical Social Worker in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Clinical Social Worker in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2015; 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.