Basic Information
Provider Information
NPI: 1124646427
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MARLEY
FirstName: FRANCES
MiddleName: GOODELL
NamePrefix:  
NameSuffix:  
Credential: M.ED., PLPC, NCC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3830 DAUPHINE ST
Address2:  
City: NEW ORLEANS
State: LA
PostalCode: 701175720
CountryCode: US
TelephoneNumber: 5048138457
FaxNumber:  
Practice Location
Address1: 2700 S BROAD ST
Address2:  
City: NEW ORLEANS
State: LA
PostalCode: 701251953
CountryCode: US
TelephoneNumber: 5048219211
FaxNumber: 5044591011
Other Information
ProviderEnumerationDate: 07/13/2020
LastUpdateDate: 07/13/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/13/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X6948LAY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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