Provider Demographics
NPI:1316410509
Name:HOWELL, MARCIA KING (LCSW)
Entity Type:Individual
Prefix:
First Name:MARCIA
Middle Name:KING
Last Name:HOWELL
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 1:3311 PINE ST APT 2
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32205-9117
Mailing Address - Country:US
Mailing Address - Phone:770-533-1093
Mailing Address - Fax:
Practice Address - Street 1:1225 W BEAVER ST STE 205
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32204-1416
Practice Address - Country:US
Practice Address - Phone:904-414-2106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-10
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW158571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty