| Marshall Clinical Social Work | |
|
12335 Cherry Branch Dr Clarksburg MD 20871-4402 | |
| (301) 910-7696 | |
| Not Available |
| Full Name | Marshall Clinical Social Work |
|---|---|
| Speciality | Clinic/Center |
| Location | 12335 Cherry Branch Dr, Clarksburg, Maryland |
| Authorized Official Name and Position | Lori Marshall (OWNER) |
| Authorized Official Contact | 3019107696 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Marshall Clinical Social Work 12335 Cherry Branch Dr Clarksburg MD 20871-4402 Ph: (301) 910-7696 | Marshall Clinical Social Work 12335 Cherry Branch Dr Clarksburg MD 20871-4402 Ph: (301) 910-7696 |
| NPI Number | 1811686371 |
|---|---|
| Provider Enumeration Date | 05/02/2023 |
| Last Update Date | 05/02/2023 |
| Certification Date | 05/02/2023 |
| Medicare PECOS PAC ID | 7719345040 |
|---|---|
| Medicare Enrollment ID | O20230620001154 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811686371 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Lori Marshall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568076032 PECOS PAC ID: 8628436953 Enrollment ID: I20230621001197 |
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