Mark Pechovnik, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

4549 Issued in OR

Practice address

2030 NE 47TH Ave Ste 725
Portland, OR 97213-2016

Phone

(503) 853-3532

NPI assigned

Jul 31, 2007

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1185840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615334400000",
    "number": "1598955940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2030 NE 47TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132016",
            "telephone_number": "503-853-3532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 NE 47TH AVE STE 725",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132016",
            "telephone_number": "503-853-3532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECHOVNIK",
        "first_name": "MARK",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-31",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "4549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mark@mountaingatetherapy.com",
            "affiliation": "N",
            "endpointDescription": "e-mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "text",
            "address_1": "2030 NE 47th Ave",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972132016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Letha Pease, LMT
• David Blanchard Peaslee, M.D.
• Amanda Leigh Peats, PMHNP
• Deziare Pebenito, LMT
• Sean Paul Pebler, CADC
• Gabriel Adrian Peck-Frame, DO
• Amy Samantha Peck
• Ashley Peck
• Cynthia Jean Peck
• Elizabeth Joann Peck, DPT

• Clinical Social Worker in Portland, OR
• Providers in Portland, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2021; 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.