Marshall, Samuel R.

Marshall, Samuel R. is an individual health care provider with primary practice located at 137 Hospital Dr. , Fort Walton Beach FL 32548-5063. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Marshall, Samuel R. can be contacted via phone (850) 833-7400.

Contact Information

Primary practice address
137 Hospital Dr. Fort Walton Beach FL 32548-5063
Phone: (850) 833-7400
Fax: (850) 833-7528
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X MH 5996 Florida

Profile Details

NPI number 1568437226
LBN Legal business name Marshall, Samuel R.
Credentials LMHC
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 17th, 2006
Last updated Jan 7th, 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 1568437226 NPPES
Florida MEDICAID 761863800

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