Provider Demographics
NPI:1952450967
Name:MARS, MARGIE PENNIE (MED, LPC)
Entity Type:Individual
Prefix:
First Name:MARGIE
Middle Name:PENNIE
Last Name:MARS
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1240 VALLEYVIEW DR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:PA
Mailing Address - Zip Code:15055-1035
Mailing Address - Country:US
Mailing Address - Phone:724-745-6611
Mailing Address - Fax:
Practice Address - Street 1:1725 WASHINGTON RD
Practice Address - Street 2:SUITE 509
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15241-1207
Practice Address - Country:US
Practice Address - Phone:412-831-8180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC002332101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1528101OtherHIGHMARK PROVIDER NUMBER