Provider Demographics
NPI:1023177003
Name:MARSH, MORIAH KARN (LICSW)
Entity type:Individual
Prefix:
First Name:MORIAH
Middle Name:KARN
Last Name:MARSH
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3156
Mailing Address - Street 2:
Mailing Address - City:GLOUCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01931-3156
Mailing Address - Country:US
Mailing Address - Phone:978-290-2976
Mailing Address - Fax:
Practice Address - Street 1:2 MAIN ST FL 3
Practice Address - Street 2:
Practice Address - City:GLOUCESTER
Practice Address - State:MA
Practice Address - Zip Code:01930-5726
Practice Address - Country:US
Practice Address - Phone:978-290-2976
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2010-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA113251104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker