Provider Demographics
NPI:1063253300
Name:NAGHSH, MARK (LMSW)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:NAGHSH
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 W 58TH ST APT 8C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-1567
Mailing Address - Country:US
Mailing Address - Phone:917-359-9352
Mailing Address - Fax:
Practice Address - Street 1:135 W 58TH ST APT 8D
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1567
Practice Address - Country:US
Practice Address - Phone:917-359-9352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY058653104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty