Provider Demographics
NPI:1346632007
Name:MARION, JOELLEN MARIE (LPCC)
Entity Type:Individual
Prefix:MS
First Name:JOELLEN
Middle Name:MARIE
Last Name:MARION
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:JOELLEN
Other - Middle Name:MARIE
Other - Last Name:HELDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:728 CHESTNUT ST STE 202
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42101-6922
Mailing Address - Country:US
Mailing Address - Phone:270-715-1178
Mailing Address - Fax:270-715-1189
Practice Address - Street 1:728 CHESTNUT ST STE 202
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42101-6922
Practice Address - Country:US
Practice Address - Phone:270-202-8669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-04
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401014177101YP2500X
MI6301015869103TC1900X
KY174708101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3402136Medicaid
KY7100494200Medicaid