Mark Ervin Mittag, MS

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

2925 Mondovi Rd
Eau Claire, WI 54701-6141

Phone

(715) 832-0238

Fax

(715) 832-0771

NPI assigned

May 21, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1274400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274400000000",
    "number": "1396064911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 MONDOVI RD",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016141",
            "telephone_number": "715-832-0238",
            "fax_number": "715-832-0771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2925 MONDOVI RD",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016141",
            "telephone_number": "715-832-0238",
            "fax_number": "715-832-0771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITTAG",
        "first_name": "MARK",
        "middle_name": "ERVIN",
        "name_prefix": "Mr.",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-21",
        "last_updated": "2010-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexis Anne Misco
• Nicholas Miskulin, D.D.S.
• Terrence L Miskulin, D.D.S.
• Benjamin Brian Mitchell, LPC-IT
• Breanna Marie Mitchell, GC
• Tiffany Moberg, C.A.P.S.W.
• Jessica Modjeski, LCSW
• Mackenzie Moessner
• Vanajakshi Mogulla, M.D.
• Muhanad Mohamed, M.D

• Mental Health Counselor in Eau Claire, WI
• Providers in Eau Claire, WI by specialty
• Mental Health Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2010; 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.