Provider Demographics
NPI:1619287695
Name:THARP, MARCIA JO (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MARCIA
Middle Name:JO
Last Name:THARP
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-2823
Mailing Address - Country:US
Mailing Address - Phone:406-756-8721
Mailing Address - Fax:406-257-4054
Practice Address - Street 1:14 RIVER RD
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-2823
Practice Address - Country:US
Practice Address - Phone:406-756-8721
Practice Address - Fax:406-257-4054
Is Sole Proprietor?:No
Enumeration Date:2010-10-08
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT973-LCSW1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical