Nicole Marie Mark, LMSW
Individual provider Active NPI Social Worker · Cisco, TX
NPI 1407546542 · NPPES record last updated May 11, 2023
Key facts
- NPI
- 1407546542
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 69418 (TX)
- Practice address
- 1601 Conrad Hilton Blvd
Cisco, TX 76437-4346 - Phone
- (254) 247-7328
- NPI assigned
- May 11, 2023
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 69418 | TX | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 69418 | TX | Yes |
Addresses
Primary practice location
1601 Conrad Hilton Blvd
Cisco, TX 76437-4346
Mailing address
1601 Conrad Hilton Blvd
Cisco, TX 76437-4346
Phone (254) 247-7328
Other names
- Nicole Stewart
Other providers in Cisco, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 11, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.