Provider Demographics
NPI:1649294547
Name:MARVIN, WILLIAM D (LCSW)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:D
Last Name:MARVIN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 N CAUSEWAY BLVD
Mailing Address - Street 2:STE.303
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-1737
Mailing Address - Country:US
Mailing Address - Phone:504-832-9929
Mailing Address - Fax:
Practice Address - Street 1:3801 N CAUSEWAY BLVD
Practice Address - Street 2:STE.303
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-1737
Practice Address - Country:US
Practice Address - Phone:504-832-9929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA29801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical