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Individual
MARK P O'DELL
Active
Individual
MARK P O'DELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
C005296
NC
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
147NF
BCBS
NC
05
—
6106809
—
NC
Enumeration date
11/28/2007
Last updated
01/03/2008
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