Provider Demographics
NPI:1083838221
Name:FOHS, MARK W (LMHC)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:W
Last Name:FOHS
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5110 VELASKO RD
Mailing Address - Street 2:SUITE 1004
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13215
Mailing Address - Country:US
Mailing Address - Phone:315-695-8683
Mailing Address - Fax:
Practice Address - Street 1:5110 VELASKO RD
Practice Address - Street 2:SUITE 1004
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13215
Practice Address - Country:US
Practice Address - Phone:315-695-8683
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000528101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health