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NPI Code Detail

MEDICARE: GLEN C MARSEY LCSW

MEDICARE: GLEN C MARSEY 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
1104100000XSocial Worker000725MO

General Provider Information

NPI Number : 1902892847
Entity Type Code : Individual
Provider Name (Legal Business Name) : GLEN C MARSEY LCSW
Provider Business Mailing Address
First Line : PO BOX 817
Second Line :
City : CAPE GIRARDEAU
State : MO
Zip : 63702-0817
Country : US
Telephone Number : 573-335-4715
Fax Number : 573-334-2303
Provider Business Practice Location Address
First Line : 1340 S SAM HOUSTON BLVD
Second Line :
City : HOUSTON
State : MO
Zip : 65483-2045
Country : US
Telephone Number : 417-967-3755
Fax Number : 417-967-2630
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2005
Last Update Date : 07/08/2007

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Directions to “ GLEN C MARSEY LCSW” Practice Location

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