Provider Demographics
NPI:1043802168
Name:MARKI SULZBACH PLLC
Entity Type:Organization
Organization Name:MARKI SULZBACH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARKI
Authorized Official - Middle Name:
Authorized Official - Last Name:SULZBACH
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHCA
Authorized Official - Phone:417-598-0350
Mailing Address - Street 1:2761 NC HWY 210 E, UNIT G
Mailing Address - Street 2:#218
Mailing Address - City:HAMPSTEAD
Mailing Address - State:NC
Mailing Address - Zip Code:28443
Mailing Address - Country:US
Mailing Address - Phone:417-598-0350
Mailing Address - Fax:
Practice Address - Street 1:14710 US HIGHWAY 17 STE 3E
Practice Address - Street 2:
Practice Address - City:HAMPSTEAD
Practice Address - State:NC
Practice Address - Zip Code:28443-3694
Practice Address - Country:US
Practice Address - Phone:417-598-0350
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-10
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty