Marianne Clark Psyd Llc

LBN: Marianne Clark Psyd Llc
Marianne Clark Psyd Llc is an health care organization with primary practice located at 3804 Church Rd , Mount Laurel NJ 08054-1106. The organization recently has only one registered license in Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), which is considered as the primary health care specialty. Marianne Clark Psyd Llc can be contacted via phone (862) 219-1125, or through Clark, Marianne via phone (862) 219-1125.

Contact Information

Primary practice address
3804 Church Rd Mount Laurel NJ 08054-1106
Phone: (862) 219-1125
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Clark, Marianne PSYD
Phone: (862) 219-1125

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X

Profile Details

NPI number 1063057610
LBN Legal business name Marianne Clark Psyd Llc
DBA Doing business as
Authorized official Clark, Marianne PSYD
Entity Organization
Organization subpart 1 No
Enumeration date Nov 7th, 2019
Last updated Nov 7th, 2019 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063057610 NPPES
New Jersey MEDICAID 77819307

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