Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MARK DAVID LICITRA, LCSW
ActiveMARK DAVID LICITRA, LCSW is a Clinical Social Worker healthcare provider located in PORTLAND, Oregon. NPI 1568821973 is currently active in the NPPES registry. Verify at CMS.
Clinical Social Worker · PORTLAND, OR
Registration Details
- NPI Number
- 1568821973
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Feb 12, 2016 (10.511192214736 yrs)
- Last Updated
- May 19, 2025
- Licenses
-
LW61618529 (WA)3920 (HI)
Practice Information
- Address
-
8613 SE 8TH AVEPORTLAND, OR, 972027002Browse OR providers · Browse ZIP 97202
- Phone
- 2154906557
- Primary Specialty
-
Clinical Social Worker
1041C0700X
- Additional Specialty
- Clinical Social Worker
Other Clinical Social Worker Providers in PORTLAND, OR
| Name | Credential | NPI |
|---|---|---|
| LAURANELL SCARFO | LCSW | 1659371169 |
| LAURA L WOZNIAK | LCSW | 1487642047 |
| SUSAN SHERWOOD | LCSW | 1144219114 |
| KAREN ST CLAIR | LCSW | 1124017199 |
| ARTICE E GEARY | LCSW | 1508856188 |
| MS. SABRINA ULLMANN MATHEWS | LCSW | 1235110248 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.