Provider Demographics
NPI:1700096864
Name:MARVEL, JANET V (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:V
Last Name:MARVEL
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 1:3505 BAYSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23518-1417
Mailing Address - Country:US
Mailing Address - Phone:757-362-0394
Mailing Address - Fax:
Practice Address - Street 1:200 CITY HALL AVE.
Practice Address - Street 2:# E
Practice Address - City:POQUOSON
Practice Address - State:VA
Practice Address - Zip Code:23662
Practice Address - Country:US
Practice Address - Phone:757-868-0072
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040059561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA245629OtherCOMM PSYCH
VA178329OtherANTHEM BLUE CROSS
VA353122OtherMENTAL HEALTH NETWORK
VA010122538Medicaid
VA083246MOtherSENTARA
VA353122OtherTRI CARE
VA083246MOtherSENTARA