Provider Demographics
NPI:1043336753
Name:MARSHALL, TONI CLAIRE (LCSW)
Entity Type:Individual
Prefix:
First Name:TONI
Middle Name:CLAIRE
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ANTOINEITE
Other - Middle Name:CLAIRE
Other - Last Name:MARSHALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 5627
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-0627
Mailing Address - Country:US
Mailing Address - Phone:530-906-8956
Mailing Address - Fax:530-823-3707
Practice Address - Street 1:2510 RUSSELL ST APT 1
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-2158
Practice Address - Country:US
Practice Address - Phone:530-906-8956
Practice Address - Fax:530-823-3707
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS148661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ45667ZMedicare PIN