DALLAS J MARK
NPI 1689955569
Counselor in San Rafael, CA

Q: What is Dallas Mark's NPI number?

The NPI number for Dallas Mark is 1689955569. It was assigned to this individual provider in the NPPES registry on September 6, 2011.

Q: What is Dallas Mark's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

Q: When was this NPI record last updated?

The NPPES record for Dallas Mark was last updated on September 6, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.

Active since September 06, 2011PECOS Enrolled

1466 LINCOLN AVE, SAN RAFAEL, CA 94901(415) 457-3755(415) 457-0849 Get Directions Write a Review

NPPES record last updated: September 6, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Dallas J Mark NPPES

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

DALLAS J MARK (NPI 1689955569) is an individual counselor in San Rafael, California and active in the NPI registry since September 2011. She is enrolled in Medicare PECOS and is a graduate of Other (2016).

NPPES Registry Identity

NPI1689955569

Entity TypeIndividualFemale

Primary Taxonomy101Y00000X

Provider Legal NameDALLAS J MARK

Location Address1466 LINCOLN AVESan Rafael, CA 94901-2021

Mailing Address1466 Lincoln AveSan Rafael, CA 94901-2021 · (415) 457-3755 · Fax (415) 457-0849

Phone(415) 457-3755

Fax(415) 457-0849

Sole ProprietorYes

Medical School CMSOtherGraduated 2016

Enumeration DateSeptember 6, 2011

✔ NPI 1689955569 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers

Taxonomy Code101Y00000X

Definition

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

1466 LINCOLN AVE, San Rafael, CA 94901

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dallas J Mark is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2961854294

PECOS Enrollment IDI20240122004619

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHRISTOPHER A JEFFERSON

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