Mark A. Premselaar, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

5782-C Issued in NV

Practice address

780 Coronado Center Dr
Suite 110-a
Henderson, NV 89052-5040

Phone

(702) 358-0464

Fax

(702) 506-0098

NPI assigned

Aug 13, 2006

Sex

Male

Sole proprietor

Yes

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

Enrolled in NV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• A New Dawn Psychotherapy Associates LLC

  • Clinical Social Worker
  • Bethlehem, PA
  • NPI 1851895163
  NPD (past)
• Collegeville Psychological Center Inc

  • Psychiatry Physician
  • Eagleville, PA
  • NPI 1851305759

  Clinical

  NPD (past)
• Kathleen Coughlin

  dba Kathleen Coughlin, LSW & Associates

  • Social Worker
  • Bethlehem, PA
  • NPI 1558576983
  NPD (past)

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286409600000",
    "number": "1518979889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 CORONADO CENTER DRIVE",
            "address_2": "SUITE 110-A",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890525056",
            "telephone_number": "702-358-0464",
            "fax_number": "702-506-0098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 CORONADO CENTER DR",
            "address_2": "SUITE 110-A",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890525040",
            "telephone_number": "702-358-0464",
            "fax_number": "702-506-0098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREMSELAAR",
        "first_name": "MARK",
        "middle_name": "A.",
        "name_prefix": "Mr.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2010-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "5782-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Premier Vein Care
• Premiere Home Services LLC
• Premise Health of Nevada Medical Hinitt PC
• Premise Health of Nevada Medical Hinitt PC (Teamsters 631 Medical Center Wigwam)
• Premise Health of Nevada Medical Hinitt PC
• Analeah Presbitero
• Barbara Presilda
• Prestige Rehab NV LLC
• Quadrillyn Pretlow
• Victoria Prevost

• Clinical Social Worker in Henderson, NV
• Providers in Henderson, NV by specialty
• Clinical Social Worker in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.