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Individual

MR. MARK JOSEPH MOHAPP

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW, CSAC

Contact information

Practice address
1271 WISCONSIN ST, B, LAKE GENEVA, WI 53147-1748
(262) 215-0826
Mailing address
1271 WISCONSIN ST, B, LAKE GENEVA, WI 53147-1748
(262) 215-0826

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
2019
WI
101YA0400X
Addiction (Substance Use Disorder) Counselor
2019-132
WI
101YA0400X
Addiction (Substance Use Disorder) Counselor
7099-135
WI
1041C0700X
Clinical Social Worker
Primary
116-123
WI
1041C0700X
Clinical Social Worker
149.004395
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10670
DEAN CARE
WI
01
137909000
MAGELLAN BID HEALTH
01
39269100
CENPATICO
WI
05
39269100
WI
01
60158
CIGNA
01
A917403
VALUE OPTIONS
Enumeration date
09/16/2005
Last updated
03/13/2013
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