MARK A DEYAB LICSW NPI 1104907732

NPI Information

NPI: 1104907732
Provider Name: MARK A DEYAB, LICSW
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

PECOS Registration: Yes

Address:
20 HOPE AVE
G-05
WALTHAM, MA
ZIP 02453
Phone: (781) 799-3949
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Mark A Deyab, LICSW is a mental health counselor in Waltham, MA with 30 years of experience. Mark A Deyab, LICSW NPI is 1104907732. 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:

20 HOPE AVE
G-05
WALTHAM, MA
ZIP 02453-721
Phone: (781) 799-3949
Fax: (781) 899-6386

The NPI 1104907732 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 10/18/2006 and was last updated on 3/17/2009.

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	101YM0800X	Counselor	Mental Health	111824	MASSACHUSETTS	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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