Provider Demographics
NPI:1467580738
Name:MARSHALL, REBECCA STCLAIR (LPC)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:STCLAIR
Last Name:MARSHALL
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 1:616 HARPETH TRACE DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221-3126
Mailing Address - Country:US
Mailing Address - Phone:615-352-3880
Mailing Address - Fax:
Practice Address - Street 1:1921 RANSOM PL
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37217-3841
Practice Address - Country:US
Practice Address - Phone:615-279-6700
Practice Address - Fax:615-279-6703
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN423101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health