Provider Demographics
NPI:1578993408
Name:VERKLER, MARK D (MSSW, LMFT)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:D
Last Name:VERKLER
Suffix:
Gender:M
Credentials:MSSW, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1121 HAMPSHIRE LN STE 120
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-4306
Mailing Address - Country:US
Mailing Address - Phone:469-296-8569
Mailing Address - Fax:214-389-9796
Practice Address - Street 1:1121 HAMPSHIRE LN STE 120
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-4306
Practice Address - Country:US
Practice Address - Phone:469-296-8569
Practice Address - Fax:214-389-9796
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-13
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4131106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist