Provider Demographics
NPI:1083772990
Name:MARSHALL, MARGARET C (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:C
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1141 CLAY AVE
Mailing Address - Street 2:
Mailing Address - City:DUNMORE
Mailing Address - State:PA
Mailing Address - Zip Code:18510-1191
Mailing Address - Country:US
Mailing Address - Phone:570-341-9110
Mailing Address - Fax:570-558-0777
Practice Address - Street 1:1141 CLAY AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:DUNMORE
Practice Address - State:PA
Practice Address - Zip Code:18510-1191
Practice Address - Country:US
Practice Address - Phone:570-341-9110
Practice Address - Fax:570-558-0777
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0126211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA110232Medicare PIN