Provider Demographics
NPI:1518081744
Name:MARSHALL, MARILYN J (LPC)
Entity Type:Individual
Prefix:
First Name:MARILYN
Middle Name:J
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 1:749 CAROL MARIE DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-5616
Mailing Address - Country:US
Mailing Address - Phone:225-205-2669
Mailing Address - Fax:
Practice Address - Street 1:9270 SIEGEN LN
Practice Address - Street 2:701
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-1998
Practice Address - Country:US
Practice Address - Phone:225-205-2669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2631101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health