Healthcare Provider Details

I. General information

NPI: 1083772990
Provider Name (Legal Business Name): MARGARET C MARSHALL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 07/24/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1141 CLAY AVE SUITE 1
DUNMORE PA
18510-1191
US

IV. Provider business mailing address

1141 CLAY AVE
DUNMORE PA
18510-1191
US

V. Phone/Fax

Practice location:
  • Phone: 570-341-9110
  • Fax: 570-558-0777
Mailing address:
  • Phone: 570-341-9110
  • Fax: 570-558-0777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW012621
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: