Marshall, Theresa Ellen

Marshall, Theresa Ellen is an individual health care provider with primary practice located at 2700 Baker St Fl 3 , Muskegon MI 49444-2157. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Marshall, Theresa Ellen can be contacted via phone (231) 737-1335.

Contact Information

Primary practice address
2700 Baker St Fl 3 Muskegon MI 49444-2157
Phone: (231) 737-1335
Fax: (231) 737-0534
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X 6801087866 Michigan
Behavioral Health & Social Service Providers / Clinical 1041C0700X 6801087866 Michigan

Profile Details

NPI number 1629117734
LBN Legal business name Marshall, Theresa Ellen
Credentials LMSW
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 5th, 2007
Last updated Jan 2nd, 2022 - about 2 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 1629117734 NPPES
Michigan MEDICAID 1629066238
Michigan MEDICAID 231858
Michigan MEDICAID 4483587

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