Provider Demographics
NPI:1881301869
Name:MARX, JUSTIN (RMHCI)
Entity type:Individual
Prefix:
First Name:JUSTIN
Middle Name:
Last Name:MARX
Suffix:
Gender:M
Credentials:RMHCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10396 GROVE ST
Mailing Address - Street 2:
Mailing Address - City:COOPER CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33328-4043
Mailing Address - Country:US
Mailing Address - Phone:954-680-6855
Mailing Address - Fax:
Practice Address - Street 1:10396 GROVE ST
Practice Address - Street 2:
Practice Address - City:COOPER CITY
Practice Address - State:FL
Practice Address - Zip Code:33328-4043
Practice Address - Country:US
Practice Address - Phone:954-680-6855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-31
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH22095101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health