Provider Demographics
NPI:1568128916
Name:DUPREE, MARCUS DUSHAWN SR
Entity Type:Individual
Prefix:
First Name:MARCUS
Middle Name:DUSHAWN
Last Name:DUPREE
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:774 SEA ISLAND PKWY UNIT 92
Mailing Address - Street 2:
Mailing Address - City:SAINT HELENA ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29920-1804
Mailing Address - Country:US
Mailing Address - Phone:843-592-8535
Mailing Address - Fax:
Practice Address - Street 1:18 SATURN CT
Practice Address - Street 2:
Practice Address - City:SAINT HELENA ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29920-6131
Practice Address - Country:US
Practice Address - Phone:843-592-6585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-10
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst