Provider Demographics
NPI:1649984477
Name:MARSHALL, LASHAWN JOANN
Entity type:Individual
Prefix:MRS
First Name:LASHAWN
Middle Name:JOANN
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 GARFIELD PL APT 3L
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-2107
Mailing Address - Country:US
Mailing Address - Phone:917-650-8067
Mailing Address - Fax:
Practice Address - Street 1:144 GARFIELD PL APT 3L
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-2107
Practice Address - Country:US
Practice Address - Phone:917-650-8067
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-06
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health