Provider Demographics
NPI:1942975537
Name:MARSHALL MENTAL HEALTH, PLLC
Entity Type:Organization
Organization Name:MARSHALL MENTAL HEALTH, PLLC
Other - Org Name:MARSHALL MENTAL HEALTH
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, PMHNP, FNP
Authorized Official - Phone:502-496-3345
Mailing Address - Street 1:1100 OUR LADYS WAY STE 215
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41101-7049
Mailing Address - Country:US
Mailing Address - Phone:502-496-3345
Mailing Address - Fax:606-222-3345
Practice Address - Street 1:1100 OUR LADYS WAY STE 215
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-7049
Practice Address - Country:US
Practice Address - Phone:606-922-8159
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-16
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty