Healthcare Provider Details

I. General information

NPI: 1144277450
Provider Name (Legal Business Name): DONNA M. MARION LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NONE NONE NONE NONE

II. Dates (important events)

Enumeration Date: 05/30/2006
Last Update Date: 07/21/2022
Certification Date: 02/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1309 S. LINDEN RD. SUITE C.
FLINT MI
48532
US

IV. Provider business mailing address

1309. S. LINDEN RD. SUITE C.
FLINT MI
48532
US

V. Phone/Fax

Practice location:
  • Phone: 810-630-1152
  • Fax: 810-630-9107
Mailing address:
  • Phone: 810-630-1152
  • Fax: 810-630-9107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801015521
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number4101006294
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6301002736
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: