Provider Demographics
NPI:1174877880
Name:CARRON, MARCELLE MARIE (LPC)
Entity type:Individual
Prefix:MRS
First Name:MARCELLE
Middle Name:MARIE
Last Name:CARRON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:MARCELLE
Other - Middle Name:MARIE
Other - Last Name:ROE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1830 BITTERN CT
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81506-5239
Mailing Address - Country:US
Mailing Address - Phone:970-216-1521
Mailing Address - Fax:855-248-6187
Practice Address - Street 1:844 GRAND AVE
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-4623
Practice Address - Country:US
Practice Address - Phone:970-216-1521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-01
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3621101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional