Provider Demographics
NPI:1346632007
Name:MARION, JOELLEN MARIE (APRN PMHNP-BC LPCC-S)
Entity type:Individual
Prefix:MS
First Name:JOELLEN
Middle Name:MARIE
Last Name:MARION
Suffix:
Gender:F
Credentials:APRN PMHNP-BC LPCC-S
Other - Prefix:
Other - First Name:JOELLEN
Other - Middle Name:MARIE
Other - Last Name:HELDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:719 DISHMAN LANE EXT APT C
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42104-4072
Mailing Address - Country:US
Mailing Address - Phone:270-202-8669
Mailing Address - Fax:270-200-8781
Practice Address - Street 1:719 DISHMAN LANE EXT APT C
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42104-4072
Practice Address - Country:US
Practice Address - Phone:270-202-8669
Practice Address - Fax:270-200-8781
Is Sole Proprietor?:No
Enumeration Date:2015-03-04
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY174708101YP2500X
MI6301015869103TC1900X
KY4030407363LP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3402136Medicaid
KY7100494200Medicaid
KY7101015880Medicaid