Provider Demographics
NPI:1861889016
Name:LEMKE, MARK THOMAS (LCSW, LCAS)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:THOMAS
Last Name:LEMKE
Suffix:
Gender:M
Credentials:LCSW, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 100181
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29202-3141
Mailing Address - Country:US
Mailing Address - Phone:828-202-5200
Mailing Address - Fax:
Practice Address - Street 1:77 MCDOWELL ST
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4435
Practice Address - Country:US
Practice Address - Phone:828-257-4745
Practice Address - Fax:828-333-5465
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-24
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21422101YA0400X
NCC0109421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty