MEDICARE: MS. MARGARET THERESA MARLAND LPC

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	000991	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	23808012	OTHER	MO	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1760492227
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARGARET THERESA MARLAND LPC

Provider Business Mailing Address
First Line	:	819 E 72ND ST
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64131-1605
Country	:	US
Telephone Number	:	816-361-8065
Fax Number	:

Provider Business Practice Location Address
First Line	:	819 E 72ND ST
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64131-1605
Country	:	US
Telephone Number	:	816-361-8065
Fax Number	:

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

Provider Enumeration Date	:	08/08/2006
Last Update Date	:	07/08/2007

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