Provider Demographics
NPI:1376899757
Name:SOKOL, MARK DANIEL (EDD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:DANIEL
Last Name:SOKOL
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 TROY ST
Mailing Address - Street 2:SUITE 10
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-3023
Mailing Address - Country:US
Mailing Address - Phone:508-677-9393
Mailing Address - Fax:508-677-1316
Practice Address - Street 1:66 TROY ST
Practice Address - Street 2:SUITE 10
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-3023
Practice Address - Country:US
Practice Address - Phone:508-677-9393
Practice Address - Fax:508-677-1316
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-03
Last Update Date:2012-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4838103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical