MEDICARE: MR. JUSTIN WILLIAM MARSH 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	SWB-2026-0266	NM

General Provider Information

NPI Number	:	1093511800
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JUSTIN WILLIAM MARSH LCSW

Provider Business Mailing Address
First Line	:	1155 N MIRANDA ST APT B3
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88005-2063
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1155 N MIRANDA ST APT B3
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88005-2063
Country	:	US
Telephone Number	:	413-320-8916
Fax Number	:

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

Provider Enumeration Date	:	02/21/2025
Last Update Date	:	03/31/2026

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