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MARK EDWARD BABCOCK L.C.S.W.
Clinical >> Social Worker >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1508984709
Individual Registrant: MARK EDWARD BABCOCK L.C.S.W.
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
1308 VIVIAN ST LONGMONT, CO 80501-3217 US
Tel: 720-635-0711 Fax: --
Tel: 720-635-0711 Fax: --
Contact information for business:
909 3RD AVE #4 LONGMONT, CO 80501-7013 US
Tel: 720-635-0711 Fax: 303-682-9197
Tel: 720-635-0711 Fax: 303-682-9197
Registration Information:
NPI: 1508984709
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 1041C0700X | Behavioral Health & Social Service Providers Social Worker Clinical | CO | 989890 |
| N | 1041C0700X | Behavioral Health & Social Service Providers Social Worker | VA | 0904001660 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
