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NPI Code Detail

MEDICARE: BRIANNA SHACOLE MARSHALL LCSW

MEDICARE: BRIANNA SHACOLE MARSHALL 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
11041C0700XClinical Social Worker9099-CNV
2104100000XSocial WorkerCA
31041C0700XClinical Social Worker98579CA

General Provider Information

NPI Number : 1770140626
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIANNA SHACOLE MARSHALL LCSW
Provider Business Mailing Address
First Line : PO BOX 6237
Second Line :
City : GOODYEAR
State : AZ
Zip : 85338-0621
Country : US
Telephone Number : 559-274-3801
Fax Number :
Provider Business Practice Location Address
First Line : 4235 W CAPITOLA AVE
Second Line :
City : FRESNO
State : CA
Zip : 93722-6010
Country : US
Telephone Number : 559-274-3801
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/28/2019
Last Update Date : 11/29/2021

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Directions to “ BRIANNA SHACOLE MARSHALL LCSW” Practice Location

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