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NPI Code Detail

MEDICARE: KATIE MARBLE LPC-MHSP

MEDICARE: KATIE MARBLE LPC-MHSP
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
1103TC1900XCounseling PsychologistLPC0000004975TN

General Provider Information

NPI Number : 1629796719
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATIE MARBLE LPC-MHSP
Provider Business Mailing Address
First Line : 509 W MAIN ST
Second Line :
City : LEBANON
State : TN
Zip : 37087-3402
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 509 W MAIN ST
Second Line :
City : LEBANON
State : TN
Zip : 37087-3402
Country : US
Telephone Number : 615-784-9209
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2022
Last Update Date : 08/16/2022

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Directions to “ KATIE MARBLE LPC-MHSP” Practice Location

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