Provider Demographics
NPI:1922181155
Name:MARKS, JAMES DOUGLAS (LMFT)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DOUGLAS
Last Name:MARKS
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:247 MULLIGAN DRIVE
Mailing Address - Street 2:
Mailing Address - City:CLYDE
Mailing Address - State:NC
Mailing Address - Zip Code:28721-4401
Mailing Address - Country:US
Mailing Address - Phone:828-593-7926
Mailing Address - Fax:828-627-8888
Practice Address - Street 1:124 LIFE WAY
Practice Address - Street 2:
Practice Address - City:CLYDE
Practice Address - State:NC
Practice Address - Zip Code:28721-6540
Practice Address - Country:US
Practice Address - Phone:828-627-5433
Practice Address - Fax:828-627-8888
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4934225100000X
NC966106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6105031Medicaid