Provider Demographics
NPI:1952766149
Name:WALDROP, MARK II (LPC)
Entity type:Individual
Prefix:MR
First Name:MARK
Middle Name:
Last Name:WALDROP
Suffix:II
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2730 S VAL VISTA DR
Mailing Address - Street 2:SUITES 146 & 137
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-1675
Mailing Address - Country:US
Mailing Address - Phone:480-471-8560
Mailing Address - Fax:888-979-8197
Practice Address - Street 1:2730 S VAL VISTA DR
Practice Address - Street 2:SUITES 146 & 137
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-1675
Practice Address - Country:US
Practice Address - Phone:480-471-8560
Practice Address - Fax:888-979-8197
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-15
Last Update Date:2015-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-15412101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health