Provider Demographics
NPI:1487196101
Name:MARSH, DAVID C (LSW, LCDCIII)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:C
Last Name:MARSH
Suffix:
Gender:M
Credentials:LSW, LCDCIII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 2ND ST NE
Mailing Address - Street 2:
Mailing Address - City:NEW PHILADELPHIA
Mailing Address - State:OH
Mailing Address - Zip Code:44663-2808
Mailing Address - Country:US
Mailing Address - Phone:234-801-2469
Mailing Address - Fax:330-364-9212
Practice Address - Street 1:204 2ND ST NE
Practice Address - Street 2:
Practice Address - City:NEW PHILADELPHIA
Practice Address - State:OH
Practice Address - Zip Code:44663-2808
Practice Address - Country:US
Practice Address - Phone:234-801-2469
Practice Address - Fax:330-364-9212
Is Sole Proprietor?:No
Enumeration Date:2016-11-11
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLCDCIII161635101YA0400X
OHS.1700070104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)