Provider Demographics
NPI:1750501730
Name:MARGE, JESSICA ELIZABETH (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:ELIZABETH
Last Name:MARGE
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 1:7834 NC 73 HWY
Mailing Address - Street 2:
Mailing Address - City:STANLEY
Mailing Address - State:NC
Mailing Address - Zip Code:28164-8719
Mailing Address - Country:US
Mailing Address - Phone:704-207-3511
Mailing Address - Fax:
Practice Address - Street 1:7834 NC 73 HWY
Practice Address - Street 2:
Practice Address - City:STANLEY
Practice Address - State:NC
Practice Address - Zip Code:28164-8719
Practice Address - Country:US
Practice Address - Phone:704-207-3511
Practice Address - Fax:704-207-3511
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical