Provider Demographics
NPI:1992953608
Name:NOWICKI, MARK L (MS - COUNSELING)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:L
Last Name:NOWICKI
Suffix:
Gender:M
Credentials:MS - COUNSELING
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91-1841 FORT WEAVER RD
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-1909
Mailing Address - Country:US
Mailing Address - Phone:808-681-3500
Mailing Address - Fax:808-681-1486
Practice Address - Street 1:333 DAIRY RD
Practice Address - Street 2:SUITE 201
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-2487
Practice Address - Country:US
Practice Address - Phone:808-877-6888
Practice Address - Fax:808-877-6860
Is Sole Proprietor?:No
Enumeration Date:2008-09-05
Last Update Date:2008-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor