MARK RICHARD AMUNDSEN DMIN NPI 1053404665

NPI Information

NPI: 1053404665
Provider Name: MARK RICHARD AMUNDSEN, DMIN
Classification: Counselor - 101YP2500X
Entity Type: Individual

Specialization: Professional

Address:
5650 N GREENBAY AVE
GLENDALE, WI
ZIP 53209
Phone: (262) 789-1191
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Mark Richard Amundsen, DMIN is a professional counselor in Glendale, WI. Mark Richard Amundsen, DMIN NPI is 1053404665. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

5650 N GREENBAY AVE
GLENDALE, WI
ZIP 53209
Phone: (262) 789-1191

The enumeration date for this NPI number is 10/2/2006 and was last updated on 7/14/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	106H00000X	Marriage & Family Therapist		LH00009180	WASHINGTON	No
2	101YP2500X	Counselor	Professional	4127-125	WISCONSIN	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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