Provider Demographics
NPI:1538170378
Name:MARLEY, STEPHEN J (MSW, LCSW)
Entity type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:J
Last Name:MARLEY
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 SADDLE BRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-8122
Mailing Address - Country:US
Mailing Address - Phone:678-525-1983
Mailing Address - Fax:678-802-0935
Practice Address - Street 1:290 SADDLE BRIDGE DR
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-8122
Practice Address - Country:US
Practice Address - Phone:678-525-1983
Practice Address - Fax:678-802-0935
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0018881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA80BBFJKMedicare ID - Type UnspecifiedCSW