Provider Demographics
NPI:1326400300
Name:MARQUEZ, MARYELLEN (LPC)
Entity type:Individual
Prefix:MS
First Name:MARYELLEN
Middle Name:
Last Name:MARQUEZ
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 HIGH ST STE 240
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2759
Mailing Address - Country:US
Mailing Address - Phone:541-357-3248
Mailing Address - Fax:
Practice Address - Street 1:777 HIGH ST STE 240
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2759
Practice Address - Country:US
Practice Address - Phone:541-357-3248
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-28
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
ORC6247101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health