Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mark Martin, CDCA166404

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1164916805

Mark Martin, CDCA166404 is an Addiction (Substance Use Disorder) Counselor in Cleveland, Ohio. Practices as a sole proprietor. Licensed in Ohio.

Licensed in
OH
In the registry since
2018

Practice location Address checks out

11811 Shaker Blvd Ste 123
Cleveland, OH 44120-1927
Phone: (216) 965-6325
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence CDCA.166404 (OH)

Record details

NPI number1164916805
Entity typeIndividual (Type 1)
GenderMale
Credentials CDCA166404
Sole proprietorYes
NPI enumeratedJune 17, 2018
Last updated in NPPESJune 17, 2018

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