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Individual
MARK AGNEW
Active
Individual
MARK AGNEW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
PC016978
PA
101YP2500X
Professional Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PC016978
STATE LICENSE
PA
Enumeration date
06/14/2021
Last updated
08/27/2025
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