Mark Vincent Sundstrom, M.S.,LICSW

Clinical Social Worker · Fayetteville, WV

Individual Active NPI

NPI number 1548473903

Practice location

209 W Maple Ave
Fayetteville, WV 25840-1413
Phone
(304) 574-2100
Fax
(304) 574-2151

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NPI record

NPI
1548473903
Entity type
Individual (Type 1)
Enumeration date
May 8, 2007
Last updated
July 9, 2007
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Clinical Social Worker Primary 1041C0700X DP00450472 WV

About Mark Sundstrom

Mark Vincent Sundstrom, M.S.,LICSW is a healthcare provider registered in the NPI registry with the primary taxonomy Clinical Social Worker (code 1041C0700X). The practice location is 209 W Maple Ave, Fayetteville, WV 25840-1413. The NPI number 1548473903 was assigned on May 8, 2007 and the record was last updated on July 9, 2007.

Mark Sundstrom lists a license in the registry: #DP00450472 (WV) for Clinical Social Worker. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Mark Vincent Sundstrom, M.S.,LICSW?

The NPI number is 1548473903.

What is the phone number of Mark Sundstrom?

The phone number listed for the practice location is (304) 574-2100.

Where is Mark Sundstrom located?

209 W Maple Ave, Fayetteville, WV 25840-1413.

What is the taxonomy code for Mark Sundstrom?

The primary taxonomy code is 1041C0700X – Clinical Social Worker.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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