Provider Demographics
NPI:1790815785
Name:GOLIKE, MARIANNE C (LCPC)
Entity Type:Individual
Prefix:
First Name:MARIANNE
Middle Name:C
Last Name:GOLIKE
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1006 STATE HIGHWAY 16
Mailing Address - Street 2:
Mailing Address - City:JERSEYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62052-2826
Mailing Address - Country:US
Mailing Address - Phone:618-535-5175
Mailing Address - Fax:
Practice Address - Street 1:1006 STATE HIGHWAY 16
Practice Address - Street 2:
Practice Address - City:JERSEYVILLE
Practice Address - State:IL
Practice Address - Zip Code:62052-2826
Practice Address - Country:US
Practice Address - Phone:618-535-5175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2016-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO180-004521101YP2500X
IL180004521101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional