Provider Demographics
NPI:1457080699
Name:MARSHALL, HELENA DANIELLE (LICSW, CADC, CGAC)
Entity Type:Individual
Prefix:MS
First Name:HELENA
Middle Name:DANIELLE
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:LICSW, CADC, CGAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 KINFIELD ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02909-5715
Mailing Address - Country:US
Mailing Address - Phone:401-871-2379
Mailing Address - Fax:
Practice Address - Street 1:70 KINFIELD ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02909-5715
Practice Address - Country:US
Practice Address - Phone:401-871-2379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-05
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RICDP00858101YA0400X
RIISW040191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty