Provider Demographics
NPI:1427299932
Name:MARSH, IVY ROSE (LCSW)
Entity type:Individual
Prefix:
First Name:IVY
Middle Name:ROSE
Last Name:MARSH
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:167 N ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97402-4203
Mailing Address - Country:US
Mailing Address - Phone:512-767-0685
Mailing Address - Fax:
Practice Address - Street 1:167 N ADAMS ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-4203
Practice Address - Country:US
Practice Address - Phone:512-767-0685
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-12
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12531458-35011041C0700X
ORL159301041C0700X
TX422931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical