Provider Demographics
NPI:1538246871
Name:MARCY, CAROL (PHD)
Entity type:Individual
Prefix:DR
First Name:CAROL
Middle Name:
Last Name:MARCY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43288 JOY LN
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:20636-2608
Mailing Address - Country:US
Mailing Address - Phone:301-373-2222
Mailing Address - Fax:301-373-2222
Practice Address - Street 1:43288 JOY LN
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:MD
Practice Address - Zip Code:20636-2608
Practice Address - Country:US
Practice Address - Phone:301-373-2222
Practice Address - Fax:301-373-2222
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD2005103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDGH68COtherBLUE CROSS AND BLUE SHIEL
MD003108OtherTRICARE
MD097301OtherMHN
MD318563OtherALLIANCE
MD127125OtherAPS
MD097301OtherMHN