Stephanie Lauren Marl, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

4704300807 Issued in MI

Practice address

29800 Adams Dr
Gibraltar, MI 48173

Phone

(734) 771-7022

NPI assigned

Sep 13, 2019

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: smarl15541@direct.hfhs.org

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 10, 2021.

{
    "created_epoch": "1568332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612915200000",
    "number": "1508416355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29800 ADAMS DR",
            "city": "GIBRALTAR",
            "state": "MI",
            "postal_code": "481739758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29800 ADAMS DR",
            "city": "GIBRALTAR",
            "state": "MI",
            "postal_code": "48173",
            "telephone_number": "734-771-7022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARL",
        "first_name": "STEPHANIE",
        "middle_name": "LAUREN",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-13",
        "last_updated": "2021-02-10",
        "certification_date": "2021-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704300807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smarl1@hfhs.org",
            "affiliation": "N",
            "address_1": "2799 W Grand Blvd",
            "city": "Detroit",
            "state": "MI",
            "country_code": "US",
            "postal_code": "482022608",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Donovan Matthew Haddix, RPH
• Warren Michael Horbal, D.D.S.
• Jennifer Lyn Johnson, MS LLP
• Elizabeth Sarah Jordan
• Nida Kased
• Karley Mason
• Mibell Home Health Care Agency LLC
• Mibell Home Health Care Agency LLC
• Brittianee Pettaway
• Physicians Plus LLC

• All providers in Gibraltar, MI
• Psychiatric/Mental Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.