Provider Demographics
NPI:1780761742
Name:CADAVERO, MARK STEVEN (MSW, LCSW)
Entity type:Individual
Prefix:MR
First Name:MARK
Middle Name:STEVEN
Last Name:CADAVERO
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1704
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:NC
Mailing Address - Zip Code:28906-8860
Mailing Address - Country:US
Mailing Address - Phone:828-837-7529
Mailing Address - Fax:828-837-8410
Practice Address - Street 1:225 VALLEY RIVER AVE STE D
Practice Address - Street 2:
Practice Address - City:MURPHY
Practice Address - State:NC
Practice Address - Zip Code:28906-3000
Practice Address - Country:US
Practice Address - Phone:828-837-7529
Practice Address - Fax:828-837-8410
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2009-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0034241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6002030Medicaid
NC2876243Medicare PIN