Provider Demographics
NPI:1811137748
Name:MARSHALL, PATRICIA DION (MA, LCMHC)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:DION
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:MA, LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 CENTRAL SQ STE 300
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-3707
Mailing Address - Country:US
Mailing Address - Phone:603-355-2244
Mailing Address - Fax:603-355-2299
Practice Address - Street 1:23 CENTRAL SQ STE 300
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-3707
Practice Address - Country:US
Practice Address - Phone:603-355-2244
Practice Address - Fax:603-355-2299
Is Sole Proprietor?:No
Enumeration Date:2009-03-05
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1227101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH81263595Medicaid