Provider Demographics
NPI:1801114210
Name:MARSEILLE, CARL (LMSW)
Entity type:Individual
Prefix:MR
First Name:CARL
Middle Name:
Last Name:MARSEILLE
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 CHURCH STREET
Mailing Address - Street 2:NYACK CONSULTATION CENTER
Mailing Address - City:NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10960-3108
Mailing Address - Country:US
Mailing Address - Phone:845-358-1677
Mailing Address - Fax:845-358-3640
Practice Address - Street 1:140 OLD ORANGEBURG ROAD
Practice Address - Street 2:ROCKLAND PSYCHIATRIC CENTER
Practice Address - City:ORANGEBURG
Practice Address - State:NY
Practice Address - Zip Code:10962
Practice Address - Country:US
Practice Address - Phone:845-359-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-10
Last Update Date:2010-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY064880104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker