Provider Demographics
NPI:1518295856
Name:MARK L. DUMDEI, INC.
Entity Type:Organization
Organization Name:MARK L. DUMDEI, INC.
Other - Org Name:ALPHA FAMILY COUNSELING
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:L
Authorized Official - Last Name:DUMDEI
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:904-886-2446
Mailing Address - Street 1:3000 HARTLEY RD
Mailing Address - Street 2:SUITE 11
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32257-8215
Mailing Address - Country:US
Mailing Address - Phone:904-886-2446
Mailing Address - Fax:904-886-2446
Practice Address - Street 1:3000 HARTLEY RD
Practice Address - Street 2:SUITE 11
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32257-8215
Practice Address - Country:US
Practice Address - Phone:904-886-2446
Practice Address - Fax:904-886-2446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-24
Last Update Date:2009-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT0001333106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty