Mault, Marion W

Mault, Marion W is an individual health care provider with primary practice located at 650 Joel Dr , Fort Campbell KY 42223-5318. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is his primary health care specialty. Mault, Marion W can be contacted via phone (270) 461-4018.

Contact Information

Primary practice address
650 Joel Dr Fort Campbell KY 42223-5318
Phone: (270) 461-4018
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 111037 Ohio
Behavioral Health & Social Service Providers / Mental Health 101YM0800X E0701119 Ohio

Profile Details

NPI number 1700027448
LBN Legal business name Mault, Marion W
Credentials LPCC
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 10th, 2009
Last updated Apr 1st, 2024 - about 2 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700027448 NPPES
Ohio MEDICAID 09425

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