Mark Halvorsen
Individual provider Active NPI Clinical Social Worker · Saint Ignace, MI
NPI 1730469008 · NPPES record last updated Aug 18, 2011
Key facts
- NPI
- 1730469008
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 6801058066 (MI)
- Practice address
- 114 W Elliott St
Saint Ignace, MI 49781-1868 - Phone
- (906) 643-8616
- Fax
- (906) 643-7194
- NPI assigned
- Aug 18, 2011
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801058066 | MI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hiawatha Community Behavioral Health Authority | Past |
Accepting new patients | |
| Hiawatha Community Mental Health Authority | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801058066 | MI | Yes |
Addresses
Primary practice location
114 W Elliott St
Saint Ignace, MI 49781-1868
Mailing address
125 N Lake St
Manistique, MI 49854-1234
Other providers in Saint Ignace, MI
- April Leigh Goeschel
- Yvonne A Goudreau
- Courtney Grant
- Great Lakes Recovery Centers
- Christopher John Gunnell
- Sarah M Halvorsen
- Theresa Harris
- Carl Hawkins
- Hearing First, Inc. St. Ignace
- Leah Heffernan
All providers in Saint Ignace, MI · Clinical Social Worker in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 18, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.