Provider Demographics
NPI:1649563032
Name:MARRETT COUNSELING SERVICE PLLC
Entity Type:Organization
Organization Name:MARRETT COUNSELING SERVICE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:MARRETT
Authorized Official - Suffix:JR
Authorized Official - Credentials:LMFT
Authorized Official - Phone:502-376-0129
Mailing Address - Street 1:8911 GREENEWAY COMMONS PL
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40220-4064
Mailing Address - Country:US
Mailing Address - Phone:502-376-0129
Mailing Address - Fax:502-690-6050
Practice Address - Street 1:8911 GREENEWAY COMMONS PL
Practice Address - Street 2:SUITE 101
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40220-4064
Practice Address - Country:US
Practice Address - Phone:502-376-0129
Practice Address - Fax:502-690-6050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-18
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0709106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty