Provider Demographics
NPI:1306399886
Name:STRAUSS, MARK (MA, LPC)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:STRAUSS
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:923 S CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-5526
Mailing Address - Country:US
Mailing Address - Phone:817-778-9071
Mailing Address - Fax:
Practice Address - Street 1:923 S CHURCH ST
Practice Address - Street 2:
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-5526
Practice Address - Country:US
Practice Address - Phone:817-778-9071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-01
Last Update Date:2016-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX72075101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health