Individual provider · Type 1 NPI
Mark Van Dyke, SAC-IT
Addiction (Substance Use Disorder) Counselor · Beloit, WI
NPI number
1740987577
Active
Practice location
2240 Prairie Ave
Beloit, WI 53511-2648
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | 20079-130 (WI) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
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About NPI 1740987577
Mark Van Dyke, SAC-IT's National Provider Identifier is 1740987577, issued on Feb 13, 2023. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Beloit, WI. The record was last updated on Feb 13, 2023.