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Provider Information for 1598808230


The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

MARTHA GRACE MARQUEZ LMHC, MCAP


Other Names:  
Professional Name: 
GRACE MARQUEZ LMHC, MCAP

Sex: Female

NPI: 1598808230
Last Updated: 2018-08-28
Certification Date:

Details

NameValue
NPI1598808230
Enumeration Date2007-02-14
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 1881 NE 26TH ST STE 201A
WILTON MANORS, FL 33305-1427
United States

Phone: 954-368-5819 | Fax:954-530-1792
 
Primary Practice Address 1881 NE 26TH ST STE 201A
WILTON MANORS, FL 33305
United States

Phone: 965-368-5819 | Fax:954-530-1792
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDFL076576700
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 101YM0800X - Counselor - Mental HealthFLMH8046
No 101YA0400X - Counselor - Addiction (Substance Use Disorder)FLCAP4063
Yes 101YP2500X - Counselor - ProfessionalFLMH8046