Active NPI
Willie Eugene Marshall
- Pastoral Counselor
- Dothan, AL
National Provider Identifier
1063139020
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pastoral Counselor
- License
- LCCT0545010922
- Practice address
- 100 Castle Dr. Apt 1
Dothan, AL 36303 - Phone
- (251) 300-0790
- NPI assigned
- Oct 20, 2022
- Last updated
- Oct 20, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pastoral Counselor | 101YP1600X | LCCT0545010922 | AL | Primary |
Addresses
Primary practice location
100 Castle Dr. Apt 1
Dothan, AL 36303
Mailing address
PO Box 10227
Dothan, AL 36304
Phone (257) 300-0790
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCCT0545010922 | AL | MD | Pastoral Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666224000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666224000000",
"number": "1063139020",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10227",
"city": "DOTHAN",
"state": "AL",
"postal_code": "36304",
"telephone_number": "257-300-0790"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 CASTLE DR. APT 1",
"city": "DOTHAN",
"state": "AL",
"postal_code": "36303",
"telephone_number": "251-300-0790"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARSHALL",
"first_name": "WILLIE",
"middle_name": "EUGENE",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-10-20",
"last_updated": "2022-10-20",
"certification_date": "2022-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YP1600X",
"taxonomy_group": "",
"desc": "Counselor, Pastoral",
"state": "AL",
"license": "LCCT0545010922",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dothan, AL
- Allison Elizabeth Marker, MD
- Bradley Tyler Marker, MD
- Barbara Jean Markow, LMT
- Lesley Cathryn Marsal, PSY.D.
- Elizabeth Amy Marshall, C.R.N.P.
- Martin Plastic and Reconstructive Surgery, PC
- Amber Tennille Martin-Bishop, D.M.D.
- Ben R Martin III, MD
- Carly Jo Martin, PHARM.D.
- Gabrielle Vania Andrena Martin, DO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.