Provider Demographics
NPI:1598434441
Name:MARQUIS, KATRINA C (LCSW)
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:C
Last Name:MARQUIS
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:KATRINA
Other - Middle Name:CRISS
Other - Last Name:MERCER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:12 STILLWATER AVE STE 7
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-3984
Mailing Address - Country:US
Mailing Address - Phone:207-941-0879
Mailing Address - Fax:207-941-0880
Practice Address - Street 1:12 STILLWATER AVE STE 7
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-3984
Practice Address - Country:US
Practice Address - Phone:207-941-0879
Practice Address - Fax:207-941-0880
Is Sole Proprietor?:No
Enumeration Date:2021-09-13
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC234531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical