Provider Demographics
NPI:1881028041
Name:KING OSBORNE, MARSHA LANELL (LPC)
Entity Type:Individual
Prefix:MRS
First Name:MARSHA
Middle Name:LANELL
Last Name:KING OSBORNE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:MARSHA
Other - Middle Name:LANELL
Other - Last Name:BUDNIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LPC
Mailing Address - Street 1:2030 SIERRA COMMONS RD UNIT 711
Mailing Address - Street 2:
Mailing Address - City:DICKINSON
Mailing Address - State:ND
Mailing Address - Zip Code:58601-5171
Mailing Address - Country:US
Mailing Address - Phone:307-259-9211
Mailing Address - Fax:
Practice Address - Street 1:2030 SIERRA COMMONS RD UNIT 711
Practice Address - Street 2:
Practice Address - City:DICKINSON
Practice Address - State:ND
Practice Address - Zip Code:58601-5171
Practice Address - Country:US
Practice Address - Phone:307-259-9211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-23
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
ARP2003034101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator