Provider Demographics
NPI:1003698598
Name:HANDELMAN, MARK (MSW)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:HANDELMAN
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 NICHOLS RD
Mailing Address - Street 2:
Mailing Address - City:GILBERTSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13776-1131
Mailing Address - Country:US
Mailing Address - Phone:267-370-1935
Mailing Address - Fax:
Practice Address - Street 1:230 NICHOLS RD
Practice Address - Street 2:
Practice Address - City:GILBERTSVILLE
Practice Address - State:NY
Practice Address - Zip Code:13776-1131
Practice Address - Country:US
Practice Address - Phone:267-370-1935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-18
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0697561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical