Mark Itzen, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW014125 Issued in PA

Practice address

6921 Frankford Ave
Suite B
Philadelphia, PA 19135-1623

Phone

(215) 332-3240

Fax

(215) 332-3241

NPI assigned

Aug 29, 2006

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

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.

• Mayfair Community Counseling Center

  • Clinical Social Worker
  • Philadelphia, PA
  • NPI 1447355391
  NPD (past)

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437267457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6921 FRANKFORD AVE",
            "address_2": "SUITE B",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191351623",
            "telephone_number": "215-332-3240",
            "fax_number": "215-332-3241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6921 FRANKFORD AVE",
            "address_2": "SUITE B",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191351623",
            "telephone_number": "215-332-3240",
            "fax_number": "215-332-3241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ITZEN",
        "first_name": "MARK",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW014125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Itkin Chiropractic PC (Northeast Rehabilitation Center)
• Gelena Itkin, PHARMD
• Olga Itkin, D.C.
• Malika Iton, CNM, WHNP
• Itreat Physical Therapy & Wellness Inc (iTreat Physical Therapy & Wellness)
• Ekaterina Itzeva
• Ann Itzkowitz, M. A.
• Marialisa Sheridan Mills Itzoe, DO/MPH
• Shakhnoza Iuldasheva
• Samuel J Ivan, MD

• Clinical Social Worker in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.