Provider Demographics
NPI:1326893686
Name:MARPLE, ALYSSA ELLEN (LMSW)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:ELLEN
Last Name:MARPLE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:169 ACORN DR
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29906-3607
Mailing Address - Country:US
Mailing Address - Phone:509-553-9452
Mailing Address - Fax:
Practice Address - Street 1:169 ACORN DR
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29906-3607
Practice Address - Country:US
Practice Address - Phone:509-553-9452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-20
Last Update Date:2024-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC16821104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker