Marine, Janice K.

Marine, Janice K. is an individual health care provider with primary practice located at 610 E Center Ave , Mooresville NC 28115-2578. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Marine, Janice K. can be contacted via phone (704) 402-1060.

Contact Information

Primary practice address
610 E Center Ave Mooresville NC 28115-2578
Phone: (704) 402-1060
Fax: (704) 406-1065
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X C004567 North Carolina

Profile Details

NPI number 1063450419
LBN Legal business name Marine, Janice K.
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 4th, 2006
Last updated Nov 2nd, 2007 - about 17 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 1063450419 NPPES
North Carolina Other 2876371A MEDICARE
North Carolina MEDICAID 6106177 MEDICARE

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