Provider Demographics
NPI:1346314028
Name:MAGUN, MARSHA (LPC)
Entity Type:Individual
Prefix:MRS
First Name:MARSHA
Middle Name:
Last Name:MAGUN
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 1:53 WHITNEY GLN
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-3701
Mailing Address - Country:US
Mailing Address - Phone:203-675-3739
Mailing Address - Fax:
Practice Address - Street 1:431 POST RD E STE 14
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-4403
Practice Address - Country:US
Practice Address - Phone:203-675-3739
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000583101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1242775Medicaid