Mark A Phillips, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1852 Issued in NH

Practice address

65 Technology Way Ste 1E3
Nashua, NH 03060

Phone

(603) 886-5565

Fax

(603) 886-8642

NPI assigned

Apr 14, 2010

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

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

{
    "created_epoch": "1271203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565222400000",
    "number": "1619293735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 TECHNOLOGY WAY STE 1E3",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030603245",
            "telephone_number": "603-886-5565",
            "fax_number": "603-886-8642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 TECHNOLOGY WAY STE 1E3",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "03060",
            "telephone_number": "603-886-5565",
            "fax_number": "603-886-8642"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22 Prospect St",
            "address_purpose": "LOCATION",
            "city": "Nashua",
            "state": "NH",
            "postal_code": "030603924",
            "country_code": "US",
            "telephone_number": "603-883-1626",
            "fax_number": "603-881-9914",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-14",
        "last_updated": "2019-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "113434",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NH",
            "license": "1852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachana Phal
• Helene Pham, PA-C
• Phil Finocchiaro, MD & Associates
• Jibin Philip
• Allison Phillips
• Michael Stuart Phillips, PH.D.
• Hugh Richard Phillis, DMD
• Philo Chiropractic Center
• Glen D Philo, DC
• Kevin Y Pho, M.D.

• Clinical Social Worker in Nashua, NH
• Providers in Nashua, NH by specialty
• Clinical Social Worker in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2019; 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.