Healthcare Provider Details

I. General information

NPI: 1346177813
Provider Name (Legal Business Name): ETHAN EUGENE MARSH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 MCCARTHY BLVD STE B
NEW BERN NC
28562-2033
US

IV. Provider business mailing address

1319 MILITARY CUTOFF RD STE CC
WILMINGTON NC
28405-3640
US

V. Phone/Fax

Practice location:
  • Phone: 252-649-2728
  • Fax: 252-649-2726
Mailing address:
  • Phone: 910-264-0494
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: