Provider Demographics
NPI:1740430917
Name:MARSHALL, ROSALYN GENEVIEVE (MSW,LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ROSALYN
Middle Name:GENEVIEVE
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:MSW,LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1517 CRICKET RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-3070
Mailing Address - Country:US
Mailing Address - Phone:919-559-2078
Mailing Address - Fax:
Practice Address - Street 1:1517 CRICKET RIDGE DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-3070
Practice Address - Country:US
Practice Address - Phone:919-559-2078
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-24
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0065401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical