Provider Demographics
NPI:1245501998
Name:VIROSTEK, MARK M (LMHC)
Entity type:Individual
Prefix:MR
First Name:MARK
Middle Name:M
Last Name:VIROSTEK
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 W MARINE VIEW DR APT N302
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-1648
Mailing Address - Country:US
Mailing Address - Phone:404-245-3655
Mailing Address - Fax:
Practice Address - Street 1:1300 W MARINE VIEW DR APT N302
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-1648
Practice Address - Country:US
Practice Address - Phone:404-245-3655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-25
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60195178101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health