Provider Demographics
NPI:1821614421
Name:TOBEN, MARLEY LASSEN (MSW, LCSWA)
Entity Type:Individual
Prefix:
First Name:MARLEY
Middle Name:LASSEN
Last Name:TOBEN
Suffix:
Gender:F
Credentials:MSW, LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1607 FOREST RD APT 16
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-3386
Mailing Address - Country:US
Mailing Address - Phone:919-619-8499
Mailing Address - Fax:
Practice Address - Street 1:7000 HARPS MILL RD STE 102
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-3241
Practice Address - Country:US
Practice Address - Phone:919-886-4052
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-19
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical