Provider Demographics
NPI:1306219621
Name:MARQUETTE, TINA EVELYN (LCSW, MSW)
Entity type:Individual
Prefix:MRS
First Name:TINA
Middle Name:EVELYN
Last Name:MARQUETTE
Suffix:
Gender:F
Credentials:LCSW, MSW
Other - Prefix:
Other - First Name:TINA
Other - Middle Name:EVELYN
Other - Last Name:MARQUETTE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:50101 GOVERNORS DR STE 280
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-9517
Mailing Address - Country:US
Mailing Address - Phone:919-530-0200
Mailing Address - Fax:
Practice Address - Street 1:50101 GOVERNORS DR STE 280
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-9517
Practice Address - Country:US
Practice Address - Phone:919-530-0200
Practice Address - Fax:919-808-4307
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-09
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0112541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty