Provider Demographics
NPI:1093017147
Name:CHARLES, MARSHA L (LPC)
Entity Type:Individual
Prefix:MRS
First Name:MARSHA
Middle Name:L
Last Name:CHARLES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 25
Mailing Address - Street 2:
Mailing Address - City:QUARRYVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17566
Mailing Address - Country:US
Mailing Address - Phone:717-786-7880
Mailing Address - Fax:
Practice Address - Street 1:135 E. MAIN STREET
Practice Address - Street 2:SUITE 2A
Practice Address - City:STRASBURG
Practice Address - State:PA
Practice Address - Zip Code:17579
Practice Address - Country:US
Practice Address - Phone:717-786-7880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-23
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC001892101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPC001892OtherPROFESSIONAL COUNSELOR LICENSE