National Provider Identifier
Mark Andrew Head, LCSW, CASAC
Mark Andrew Head, LCSW, CASAC is listed in the NPPES registry with a primary specialty of Clinical Social Worker in Rochester, NY and a listed phone number of (585) 507-2871.
Profile Overview
- NPI
- 1558486894
- Provider Type
- Individual
- Primary Specialty
- Clinical Social Worker
- Enumeration Date
- March 19, 2007
- Last Updated
- July 08, 2007
Practice Location
- 877 Elmwood Ave
- Rochester, NY 14620-2933
Phone: (585) 507-2871
Specialties
- Clinical Social Worker (1041C0700X)
Full Record
- NPI
- 1558486894
- Entity Type
- Individual
- Last Name
- Head
- First Name
- Mark
- Middle Name
- Andrew
- Name Prefix
- Mr.
- Credential
- LCSW, CASAC
- Provider Other Last Name
- Head
- Provider Other First Name
- Mark
- Provider Other Middle Name
- Andrew
- Provider Other Credential Text
- LCSW, CASAC
- Provider Other Last Name Type Code
- 2
- Mailing Street Address
- 877 Elmwood Ave
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14620-2933
- Mailing Country
- US
- Mailing Phone
- (585) 507-2871
- Mailing Fax
- (585) 442-5032
- Practice Street Address
- 877 Elmwood Ave
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14620-2933
- Practice Country
- US
- Practice Phone
- (585) 507-2871
- Practice Fax
- (585) 442-5032
- Enumeration Date
- March 19, 2007
- Last Updated
- July 08, 2007
- Sex
- Male
- Sole Proprietor
- Yes
- Taxonomies
- Clinical Social Worker (1041C0700X)
- Other Identifiers
- RO28217 (NY, Clinical Social Worker)