Marlene McDermott, LMFT
Individual provider Active NPI Marriage & Family Therapist · Seligman, MO
NPI 1629410378 · NPPES record last updated Feb 6, 2014
Key facts
- NPI
- 1629410378
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 37FI00164600 (NJ)
- Practice address
- 33380 State Highway 112
Seligman, MO 65745-7344 - Phone
- (856) 685-4562
- NPI assigned
- Jul 23, 2013
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37FI00164600 | NJ | MD | Marriage & Family Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 37FI00164600 | NJ | Yes |
Addresses
Primary practice location
33380 State Highway 112
Seligman, MO 65745-7344
Mailing address
33380 State Highway 112
Seligman, MO 65745-7344
Phone (856) 685-4562
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 6, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.