Healthcare Provider Details

I. General information

NPI: 1336069509
Provider Name (Legal Business Name): CARLI MARSHALL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1372 N SUSQUEHANNA TRL STE 330
SELINSGROVE PA
17870-8974
US

IV. Provider business mailing address

9 CHRISLYNN DR
MIDDLEBURG PA
17842-9304
US

V. Phone/Fax

Practice location:
  • Phone: 570-743-2323
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: