MEDICARE: MRS. SHOMBEE MONIQUE MARSHALL MS, LPC, NCC

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	101YM0800X	Mental Health Counselor	8817	SC
2	101YP2500X	Professional Counselor	8817	SC

General Provider Information

NPI Number	:	1386238269
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHOMBEE MONIQUE MARSHALL MS, LPC, NCC

Provider Business Mailing Address
First Line	:	4703 CASCADE AVE
Second Line	:
City	:	ROCK HILL
State	:	SC
Zip	:	29732-8190
Country	:	US
Telephone Number	:	240-565-7877
Fax Number	:

Provider Business Practice Location Address
First Line	:	4703 CASCADE AVE
Second Line	:
City	:	ROCK HILL
State	:	SC
Zip	:	29732-8190
Country	:	US
Telephone Number	:	240-565-7877
Fax Number	:

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

Provider Enumeration Date	:	02/22/2021
Last Update Date	:	02/29/2024

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