Provider Demographics
NPI:1740747914
Name:MAUPIN, MARK J (MSW)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:J
Last Name:MAUPIN
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:291 BRYSON CIR UNIT 101
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-4398
Mailing Address - Country:US
Mailing Address - Phone:757-303-6335
Mailing Address - Fax:
Practice Address - Street 1:291 BRYSON CIR
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-4398
Practice Address - Country:US
Practice Address - Phone:757-303-6335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-25
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health