NPI
Mark Richard Amundsen
NPI 1053404665
Read from the NPPES registry on October 23, 2026.
Facts
- Status
- Active
- Credential
- DMin
- Type
- Individual
- Enumeration date
- 2006-10-02
- Last updated
- 2022-07-14
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Specialties
Licenses
- License WA
- LH00009180
- License WI
- 4127-125
Location
- Practice location
- 5650 N Greenbay Ave
- City
- Glendale WI
- Postal code
- 53209
- Phone
- (262) 789-1191
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
No exclusion found for this NPI in the OIG LEIE file dated October 9, 2026. Confirm on OIG's online search.
Nearby
Professional Counselors in Glendale, WI. 66 with this primary taxonomy in the public file.
Other NPIs in Glendale, WI. 793 records in the public file.
Public data from NPPES and CMS. Not a credentialing determination.
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