MR. JOE ROBERSON MARDIS LCPC NPI 1346307675

NPI Information

NPI: 1346307675
Provider Name: MR. JOE ROBERSON MARDIS, LCPC
Classification: Counselor - 101YP2500X
Entity Type: Individual

Specialization: Professional

Address:
1725 187TH ST
HOMEWOOD, IL
ZIP 60430
Phone: (708) 906-8816
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MR. Joe Roberson Mardis, LCPC is a professional counselor in Homewood, IL. MR. Joe Roberson Mardis, LCPC NPI is 1346307675. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1725 187TH ST
HOMEWOOD, IL
ZIP 60430-853
Phone: (708) 906-8816
Fax: (708) 922-0907

The enumeration date for this NPI number is 1/3/2007 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YP2500X	Counselor	Professional	180-002029	ILLINOIS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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