Provider Demographics
NPI:1386789774
Name:ALLARD, MARK E (LICSW)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:E
Last Name:ALLARD
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 SOWAMS RD
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:RI
Mailing Address - Zip Code:02806-4602
Mailing Address - Country:US
Mailing Address - Phone:508-998-2700
Mailing Address - Fax:508-998-2176
Practice Address - Street 1:4364 ACUSHNET AVE
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02745-4614
Practice Address - Country:US
Practice Address - Phone:508-998-2700
Practice Address - Fax:508-998-2176
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2008-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10166461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical