Provider Demographics
NPI:1093031627
Name:MARLATT, KAREN E (LICSW)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:E
Last Name:MARLATT
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3240 SW 34TH ST
Mailing Address - Street 2:UNIT 1120
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-8417
Mailing Address - Country:US
Mailing Address - Phone:857-998-8993
Mailing Address - Fax:
Practice Address - Street 1:3240 SW 34TH STREET
Practice Address - Street 2:UNIT 1120
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474
Practice Address - Country:US
Practice Address - Phone:857-998-8993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-07
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10319101041C0700X
FLSW104831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical