Provider Demographics
NPI:1124075668
Name:CADWALLADER, MARSHA HALLMAN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:MARSHA
Middle Name:HALLMAN
Last Name:CADWALLADER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2818 SADDLE DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27712-3700
Mailing Address - Country:US
Mailing Address - Phone:919-382-8967
Mailing Address - Fax:
Practice Address - Street 1:3310 CROASDAILE DR
Practice Address - Street 2:SUITE 700
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-6806
Practice Address - Country:US
Practice Address - Phone:919-630-8202
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0025961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical