Provider Demographics
NPI:1760866826
Name:MARSHA BARNOSKY LLC
Entity Type:Organization
Organization Name:MARSHA BARNOSKY LLC
Other - Org Name:MARSHA BARNOSKY COACHING AND CONSULTING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARSHA
Authorized Official - Middle Name:MCDANIEL
Authorized Official - Last Name:BARNOSKY
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW, ACSW
Authorized Official - Phone:616-402-8324
Mailing Address - Street 1:2496 E TURNING LEAF WAY
Mailing Address - Street 2:
Mailing Address - City:FRUITPORT
Mailing Address - State:MI
Mailing Address - Zip Code:49415-8880
Mailing Address - Country:US
Mailing Address - Phone:616-402-8327
Mailing Address - Fax:616-974-6459
Practice Address - Street 1:950 TAYLOR AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:GRAND HAVEN
Practice Address - State:MI
Practice Address - Zip Code:49417-2282
Practice Address - Country:US
Practice Address - Phone:616-402-8327
Practice Address - Fax:616-974-6459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-17
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801019680261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health