Provider Demographics
NPI:1700412822
Name:VERNAL, MARIE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:
Last Name:VERNAL
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 1:3100 UNIVERSITY BLVD S STE 218
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-2727
Mailing Address - Country:US
Mailing Address - Phone:904-834-9843
Mailing Address - Fax:
Practice Address - Street 1:3100 UNIVERSITY BLVD S STE 218
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-2727
Practice Address - Country:US
Practice Address - Phone:904-834-9843
Practice Address - Fax:904-834-9843
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-20
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker