Black, Marvin Talmage

Black, Marvin Talmage is an individual health care provider with primary practice located at 11265 Alumni Way , Jacksonville FL 32246-6685. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Black, Marvin Talmage can be contacted via phone (904) 398-2020.

Contact Information

Primary practice address
11265 Alumni Way Jacksonville FL 32246-6685
Phone: (904) 398-2020
Fax: (904) 724-2172
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X MH3241 Florida

Profile Details

NPI number 1689799355
LBN Legal business name Black, Marvin Talmage
Credentials MS, LMHC
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 20th, 2007
Last updated Jul 8th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689799355 NPPES
Florida MEDICAID 762457300

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