Provider Demographics
NPI:1902322027
Name:MARSHALL, KARISSA JANAY (LMFT)
Entity type:Individual
Prefix:MISS
First Name:KARISSA
Middle Name:JANAY
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:485 BLUE TEAL DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:OH
Mailing Address - Zip Code:45246-1528
Mailing Address - Country:US
Mailing Address - Phone:423-331-4707
Mailing Address - Fax:
Practice Address - Street 1:3012 GLENMORE AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45238-2269
Practice Address - Country:US
Practice Address - Phone:513-914-1815
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-21
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
OHM.2200210106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator