Provider Demographics
NPI:1669864583
Name:MARSCHIK, THERESA L (LCSW)
Entity Type:Individual
Prefix:MS
First Name:THERESA
Middle Name:L
Last Name:MARSCHIK
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 1:2512 LAKECREST DR
Mailing Address - Street 2:
Mailing Address - City:MOORE
Mailing Address - State:OK
Mailing Address - Zip Code:73170-7475
Mailing Address - Country:US
Mailing Address - Phone:405-246-6800
Mailing Address - Fax:
Practice Address - Street 1:2512 LAKECREST DR
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:OK
Practice Address - Zip Code:73170-7475
Practice Address - Country:US
Practice Address - Phone:405-246-6800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-02
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK46661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical