Marian Allen, LMSW

Individual provider Active NPI Clinical Social Worker · Hattiesburg, MS

NPI 1043615313 · NPPES record last updated Oct 29, 2014

Key facts

NPI
1043615313
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
M5242 (MS)
Practice address
4100 Mamie St
Hattiesburg, MS 39402-1735
Phone
(601) 705-1906
NPI assigned
Oct 29, 2014
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
M5242MSMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X M5242 MS Yes

Addresses

Primary practice location

4100 Mamie St
Hattiesburg, MS 39402-1735

Mailing address

110 Patton Ave
Hattiesburg, MS 39401-6155
Phone (601) 582-1111

Other providers in Hattiesburg, MS

All providers in Hattiesburg, MS · Clinical Social Worker in Mississippi

Sources for this page

Verify at the official NPI Registry.