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MARK RICHARD AMUNDSEN DMIN
NPI 1053404665
Counselor - Professional in Glendale, WI

Active since October 02, 2006
5650 N GREENBAY AVE, GLENDALE, WI 53209(262) 789-1191 Get Directions Write a Review

NPPES record last updated: July 14, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mark Richard Amundsen Dmin NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARK RICHARD AMUNDSEN DMIN (NPI 1053404665) is an individual professional provider in Glendale, Wisconsin, licensed in Wisconsin (4127-125) and active in the NPI registry since October 2006.

NPPES Registry Identity

NPI1053404665
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameMARK RICHARD AMUNDSENCredential: DMIN
Location Address5650 N GREENBAY AVEGlendale, WI 53209
Mailing Address5650 N Greenbay AveGlendale, WI 53209 · (262) 789-1191
Phone(262) 789-1191
Sole ProprietorNo
Enumeration DateOctober 2, 2006
Last NPPES UpdateJuly 14, 2022
NPPES CertifiedJuly 1, 2022
✔ NPI 1053404665 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in WI · 4127-125
Also ListedMarriage & Family TherapistTaxonomy 106H00000X · License LH00009180 (WA)
5650 N GREENBAY AVE, Glendale, WI 53209
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mark Amundsen's NPI number?

The NPI number for Mark Amundsen is 1053404665. It was assigned to this individual provider in the NPPES registry on October 2, 2006.

Where is Mark Amundsen located?

Mark Amundsen practices at 5650 N Greenbay Ave, Glendale, WI 53209. The listed phone number is (262) 789-1191.

What is Mark Amundsen's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

When was this NPI record last updated?

The NPPES record for Mark Amundsen was last updated on July 14, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.