MEDICARE: MS. JANICE ELAINE MARR LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	2046	OK

General Provider Information

NPI Number	:	1083840185
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JANICE ELAINE MARR LCSW

Provider Business Mailing Address
First Line	:	1712 S 152ND WEST AVE
Second Line	:
City	:	SAND SPRINGS
State	:	OK
Zip	:	74063-4245
Country	:	US
Telephone Number	:	918-857-7944
Fax Number	:

Provider Business Practice Location Address
First Line	:	1712 S 152ND WEST AVE
Second Line	:
City	:	SAND SPRINGS
State	:	OK
Zip	:	74063-4245
Country	:	US
Telephone Number	:	918-857-7944
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2009
Last Update Date	:	08/13/2025

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