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Susan Mark

Peer Specialist β€’ Longview, WA

Active NPI 1295356236 Individual Practitioner Female Practitioner
Practice location in NPPES

720 14th Ave
Longview, WA 986322315

Call 3604230203 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

720 14th Ave

Longview, WA 986322315

Telephone 3604230203
Fax 3605770187
Organization at the Same NPPES Address or Phone
Lower Columbia Pathologists Ps Facility NPI 1174564025

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2020

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Longview and Washington

105 active clinicians are listed under Peer Specialist with a practice address in Longview, WA (2,632 in Washington).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Longview

0% of these 105 clinicians have the CMS telehealth indicator.

0% of these 105 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2021-09-23
Peer Specialist Primary Specialty

NUCC Taxonomy Code: 175T00000X

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Washington State Department of Health Provider Lookup.
Look Up on State Board Site

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

2 listed
Harrison Detroja , MSN, PMHNP-BC

Nurse Practitioner - Psychiatric/Mental Health

NPI 1154670628

Master of Science in Nursing, Psychiatric-Mental Health Nurse Practitioner (Board Certified)

David Paris , PMHNP-BC

Nurse Practitioner - Psychiatric/Mental Health

NPI 1073666848

Psychiatric-Mental Health Nurse Practitioner (Board Certified)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

9 Historical Events
πŸ‘€
Provider Name / Credentials Updated September 23, 2021

Recorded as SUSAN MARK

πŸ“
Updated Practice Location September 07, 2021

Registered at 720 14TH AVE, LONGVIEW, WA 986322315 (Tel: 3604230203)

πŸ“
Updated Business Mailing Address September 07, 2021

Registered at PO BOX 1847, LONGVIEW, WA 986328140 (Tel: 3604230203)

βœ…
NPI Profile Active April 30, 2020

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) April 30, 2020

Registered at 6926 NE FOURTH PLAIN BLVD, VANCOUVER, WA 986617254 (Tel: 3609933000)

πŸ“
Business Mailing Address (Initial Record) April 30, 2020

Registered at 6926 NE FOURTH PLAIN BLVD, VANCOUVER, WA 986617254

πŸ‘€
Provider Name / Credentials (Initial Record) April 30, 2020

Recorded as SUSAN MORDICK

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) April 30, 2020

Peer Specialist

🟒
Initial NPI Registration & Enumeration April 30, 2020

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1295356236
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 30, 2020
Last Update: September 23, 2021
Sole Proprietor: No

Mailing Address

Po Box 1847

Longview, WA 986328140

Phone: 3604230203

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.