Provider Demographics
NPI:1144703737
Name:MARKUM, DONALD CHARLES (MSW - LICSW)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:CHARLES
Last Name:MARKUM
Suffix:
Gender:M
Credentials:MSW - LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 FOX LN
Mailing Address - Street 2:
Mailing Address - City:FOXBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02035-1563
Mailing Address - Country:US
Mailing Address - Phone:508-698-9043
Mailing Address - Fax:
Practice Address - Street 1:22 FOX LN
Practice Address - Street 2:
Practice Address - City:FOXBORO
Practice Address - State:MA
Practice Address - Zip Code:02035-1563
Practice Address - Country:US
Practice Address - Phone:508-698-9043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-11
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical