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MARK DAVID LICITRA LCSW
NPI 1568821973
Social Worker - Clinical in Portland, OR

Active since February 12, 2016
8613 SE 8TH AVE, PORTLAND, OR 97202(215) 490-6557 Get Directions Write a Review

NPPES record last updated: May 19, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: May 19, 2025, Feb 12, 2016 (2 updates tracked since 2016).

About Mark David Licitra Lcsw NPPES

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

MARK DAVID LICITRA LCSW (NPI 1568821973) is an individual clinical provider in Portland, Oregon, licensed in Hawaii (3920) and active in the NPI registry since February 2016. He maintains a secondary practice location in Portland.

NPPES Registry Identity

NPI1568821973
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameMARK DAVID LICITRACredential: LCSW
Location Address8613 SE 8TH AVEPortland, OR 97202-7002
Mailing Address8613 Se 8th AvePortland, OR 97202-7002 · (215) 490-6557
Phone(215) 490-6557
Sole ProprietorNo
Enumeration DateFebruary 12, 2016
Last NPPES UpdateMay 19, 20252 updates tracked since enumeration
NPPES CertifiedMay 19, 2025
✔ NPI 1568821973 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Licenses✔ Licensed in HI · 3920✔ Licensed in WA · LW61618529
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
8613 SE 8TH AVE, Portland, OR 97202
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Secondary Practice Location 1

Location 13710 SW US Veterans Hospital RdPortland, OR 97239-2964 · Phone (503) 220-8262 ext. 54220

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 Licitra's NPI number?

The NPI number for Mark Licitra is 1568821973. It was assigned to this individual provider in the NPPES registry on February 12, 2016.

Where is Mark Licitra located?

Mark Licitra practices at 8613 SE 8th Ave, Portland, OR 97202. The listed phone number is (215) 490-6557.

What is Mark Licitra's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

When was this NPI record last updated?

The NPPES record for Mark Licitra was last updated on May 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months 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.