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Provider Information for 1891800579


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ELIZABETH A MARSH LMHC


Sex: Female

NPI: 1891800579
Last Updated: 2016-12-28
Certification Date:

Details

NameValue
NPI1891800579
Enumeration Date2006-08-20
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address PO BOX 1559
BARTOW, FL 33831-1559
United States

Phone: 863-519-0575 | Fax:
 
Primary Practice Address 1239 E MAIN ST
BARTOW, FL 33830-5058
United States

Phone: 863-519-0575 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDFL019442200
Other (non-Medicare)FLZ077RBlue Cross Blue Shield
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 101YM0800X - Counselor - Mental HealthFLMH7714