Provider Demographics
NPI:1134359532
Name:JAMES, MARK S (LCSW)
Entity type:Individual
Prefix:MR
First Name:MARK
Middle Name:S
Last Name:JAMES
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:QUANAH
Mailing Address - State:TX
Mailing Address - Zip Code:79252-4704
Mailing Address - Country:US
Mailing Address - Phone:940-663-2100
Mailing Address - Fax:940-663-2150
Practice Address - Street 1:200 W 5TH ST
Practice Address - Street 2:
Practice Address - City:QUANAH
Practice Address - State:TX
Practice Address - Zip Code:79252-4704
Practice Address - Country:US
Practice Address - Phone:940-663-2100
Practice Address - Fax:940-663-2150
Is Sole Proprietor?:No
Enumeration Date:2009-07-20
Last Update Date:2009-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX183781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical