MEDICARE: JOAN LESLIE MARINEAU LMHC

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
1	101YM0800X	Mental Health Counselor	MH3222	FL

General Provider Information

NPI Number	:	1528136025
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOAN LESLIE MARINEAU LMHC

Provider Business Mailing Address
First Line	:	573 US HWY 1, STE 2
Second Line	:
City	:	NORTH PALM BEACH
State	:	FL
Zip	:	33408
Country	:	US
Telephone Number	:	561-848-9344
Fax Number	:

Provider Business Practice Location Address
First Line	:	424 KELSEY PARK DR
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-4512
Country	:	US
Telephone Number	:	561-848-9344
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2006
Last Update Date	:	07/08/2007

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