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

Mark Mixdorf, ICSW

Individual provider Clinical Social Worker · NPI 1659387603

Mark Mixdorf, ICSW is a Clinical Social Worker in Wausau, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2006.

Licensed in
WI
In the registry since
2006

Practice location Address checks out

1100 Lake View Dr
Wausau, WI 54403-6785
Phone: (715) 848-4600
Fax: (715) 845-5398
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 2541-123 (WI)

Record details

NPI number1659387603
Entity typeIndividual (Type 1)
GenderMale
Credentials ICSW
Sole proprietorNo
NPI enumeratedJuly 31, 2006
Last updated in NPPESJuly 8, 2007
Mailing address1100 Lake View Dr, Wausau, WI 54403-6785

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