Provider Demographics
NPI:1437294261
Name:HOOLIHAN, MARK HAROLD (LCSW)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:HAROLD
Last Name:HOOLIHAN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:826 CHILTON AVE
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14301-1106
Mailing Address - Country:US
Mailing Address - Phone:716-285-6984
Mailing Address - Fax:716-285-6984
Practice Address - Street 1:826 CHILTON AVE
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14301-1106
Practice Address - Country:US
Practice Address - Phone:716-285-6984
Practice Address - Fax:716-285-6984
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR041855-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical