Provider Demographics
NPI:1205246469
Name:TEMPLE, MARCIE JULIAN (MS; LPC)
Entity type:Individual
Prefix:
First Name:MARCIE
Middle Name:JULIAN
Last Name:TEMPLE
Suffix:
Gender:F
Credentials:MS; LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:737 LAMAR AVE
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75460-4479
Mailing Address - Country:US
Mailing Address - Phone:903-785-0400
Mailing Address - Fax:903-785-0403
Practice Address - Street 1:737 LAMAR AVE
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-4479
Practice Address - Country:US
Practice Address - Phone:903-785-0400
Practice Address - Fax:903-785-0403
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-28
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69709101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health