Provider Demographics
NPI:1023825742
Name:MARSHALL, LIPHAHLEE W (LCSW)
Entity type:Individual
Prefix:
First Name:LIPHAHLEE
Middle Name:W
Last Name:MARSHALL
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 1:59 KAYE VUE DR APT D
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06514-2315
Mailing Address - Country:US
Mailing Address - Phone:860-338-5396
Mailing Address - Fax:
Practice Address - Street 1:299 WASHINGTON AVE STE 2A
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518-3034
Practice Address - Country:US
Practice Address - Phone:860-276-4459
Practice Address - Fax:203-718-6002
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-16
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0134531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical