Provider Demographics
NPI:1285717629
Name:MARIEN, SHIRLEY (LMFT)
Entity type:Individual
Prefix:MRS
First Name:SHIRLEY
Middle Name:
Last Name:MARIEN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:667 LIGHTHOUSE AVE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:PACIFIC GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:93950-2665
Mailing Address - Country:US
Mailing Address - Phone:831-656-0883
Mailing Address - Fax:
Practice Address - Street 1:667 LIGHTHOUSE AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:PACIFIC GROVE
Practice Address - State:CA
Practice Address - Zip Code:93950-2665
Practice Address - Country:US
Practice Address - Phone:831-656-0883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT29075106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist