Provider Demographics
NPI:1578567293
Name:CHAMLEE, MARILYN FRANCINE (LMHC, RN)
Entity Type:Individual
Prefix:
First Name:MARILYN
Middle Name:FRANCINE
Last Name:CHAMLEE
Suffix:
Gender:F
Credentials:LMHC, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3215 38TH ST N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-2341
Mailing Address - Country:US
Mailing Address - Phone:727-527-4063
Mailing Address - Fax:727-527-8293
Practice Address - Street 1:10707 66TH ST
Practice Address - Street 2:STE 15
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33782-2352
Practice Address - Country:US
Practice Address - Phone:727-527-4063
Practice Address - Fax:727-527-8293
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-09
Last Update Date:2009-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH4043101YM0800X
FLRN1673612163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health