Provider Demographics
NPI:1306122528
Name:GOERING, MARK ANDREW (LSCSW)
Entity type:Individual
Prefix:MR
First Name:MARK
Middle Name:ANDREW
Last Name:GOERING
Suffix:
Gender:M
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1600 N LORRAINE ST
Mailing Address - Street 2:STE 202
Mailing Address - City:HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67501-5670
Mailing Address - Country:US
Mailing Address - Phone:620-663-7595
Mailing Address - Fax:620-663-5263
Practice Address - Street 1:1600 N LORRAINE ST
Practice Address - Street 2:STE 202
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67501-5670
Practice Address - Country:US
Practice Address - Phone:620-663-7595
Practice Address - Fax:620-663-5263
Is Sole Proprietor?:No
Enumeration Date:2011-11-02
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS82651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical