Active NPI
Christopher Mark
- Clinical Social Worker
- Gaithersburg, MD
National Provider Identifier
1417307364
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 03871
- Practice address
- 16220 Frederick Rd
Suite 502
Gaithersburg, MD 20877-4039 - Phone
- (301) 978-9750
- NPI assigned
- Jun 21, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 03871 | MD | Primary |
Addresses
Primary practice location
16220 Frederick Rd
Suite 502
Gaithersburg, MD 20877-4039
Mailing address
23513 Elk Grove Ter
Damascus, MD 20872-2908
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03871 | MD | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1466467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1466467200000",
"number": "1417307364",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23513 ELK GROVE TER",
"city": "DAMASCUS",
"state": "MD",
"postal_code": "208722908"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16220 FREDERICK RD",
"address_2": "SUITE 502",
"city": "GAITHERSBURG",
"state": "MD",
"postal_code": "208774039",
"telephone_number": "301-978-9750"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARK",
"first_name": "CHRISTOPHER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-06-21",
"last_updated": "2016-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "03871",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gaithersburg, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.