Provider Demographics
NPI:1891223970
Name:OXAMENDI, MARSHA KELLY (LCSW)
Entity Type:Individual
Prefix:
First Name:MARSHA
Middle Name:KELLY
Last Name:OXAMENDI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1293 CORDOVA CIR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32317-8480
Mailing Address - Country:US
Mailing Address - Phone:850-556-4797
Mailing Address - Fax:
Practice Address - Street 1:555 N BYRON BUTLER PKWY
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:FL
Practice Address - Zip Code:32347-2315
Practice Address - Country:US
Practice Address - Phone:850-329-5776
Practice Address - Fax:888-974-6195
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW119521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical