Provider Demographics
NPI:1750554168
Name:WIND, MARK N (PHD, LMHC)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:N
Last Name:WIND
Suffix:
Gender:M
Credentials:PHD, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 W 15TH ST
Mailing Address - Street 2:SUITE # 609
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-6821
Mailing Address - Country:US
Mailing Address - Phone:212-929-4390
Mailing Address - Fax:
Practice Address - Street 1:10 W 15TH ST
Practice Address - Street 2:SUITE # 609
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-6838
Practice Address - Country:US
Practice Address - Phone:212-929-4390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-07
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4651101YA0400X
NY000344-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)