Marine, Janice K.
Marine, Janice K. is an individual health care provider with primary practice located at 610 E Center Ave , Mooresville NC 28115-2578. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Marine, Janice K. can be contacted via phone (704) 402-1060.Contact Information
Primary practice address
610 E Center Ave
Mooresville NC 28115-2578
Phone: (704) 402-1060
Fax: (704) 406-1065
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | C004567 | North Carolina |
Profile Details
| NPI number | 1063450419 |
|---|---|
| LBN Legal business name | Marine, Janice K. |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 4th, 2006 |
| Last updated | Nov 2nd, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063450419 | NPPES |
| North Carolina | Other | 2876371A | MEDICARE |
| North Carolina | MEDICAID | 6106177 | MEDICARE |
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