Tack, Mark

Tack, Mark is an individual health care provider with primary practice located at 7424 Apennines Dr Army Substance Abuse Program (Asap), Fort Riley KS 66442-7151. He recently has only one registered license in Behavioral Health & Social Service Providers / Social Worker, which is considered as his primary health care specialty. Tack, Mark can be contacted via phone (785) 239-0662.

Contact Information

Primary practice address
7424 Apennines Dr Army Substance Abuse Program (Asap) Fort Riley KS 66442-7151
Phone: (785) 239-0662
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X 9430 Kansas
Behavioral Health & Social Service Providers / Social Worker 104100000X ISW 8702 Florida

Profile Details

NPI number 1184083206
LBN Legal business name Tack, Mark
Credentials LMSW, ADC
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 17th, 2016
Last updated Feb 17th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184083206 NPPES
Kansas Other 9430 LICENSED MASTER SOCIAL WORKER
Kansas Other ISW 8702 LICENSED MASTER SOCIAL WORKER

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