Provider Demographics
NPI:1366699860
Name:NODO, MARK W (M ED, PCC)
Entity type:Individual
Prefix:MR
First Name:MARK
Middle Name:W
Last Name:NODO
Suffix:
Gender:M
Credentials:M ED, PCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2342 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43209-2335
Mailing Address - Country:US
Mailing Address - Phone:614-231-9400
Mailing Address - Fax:
Practice Address - Street 1:2342 E MAIN ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43209-2335
Practice Address - Country:US
Practice Address - Phone:614-231-9400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-26
Last Update Date:2012-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.0601096101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional