Provider Demographics
NPI:1821703323
Name:MARABLE, JOHNITA CIARA (MED, LCMHCA)
Entity Type:Individual
Prefix:MS
First Name:JOHNITA
Middle Name:CIARA
Last Name:MARABLE
Suffix:
Gender:F
Credentials:MED, LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3300 BATTLEGROUND AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-2490
Mailing Address - Country:US
Mailing Address - Phone:336-285-7173
Mailing Address - Fax:336-285-7174
Practice Address - Street 1:3300 BATTLEGROUND AVE STE 202
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-2490
Practice Address - Country:US
Practice Address - Phone:336-285-7173
Practice Address - Fax:336-285-7174
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-18
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA17574101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health