Provider Demographics
NPI:1609962794
Name:MARSHMAN, SERENA (LMSW CSW)
Entity type:Individual
Prefix:
First Name:SERENA
Middle Name:
Last Name:MARSHMAN
Suffix:
Gender:F
Credentials:LMSW CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1431 W LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-1847
Mailing Address - Country:US
Mailing Address - Phone:248-894-0627
Mailing Address - Fax:248-645-0087
Practice Address - Street 1:1880 STAR BATT DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48309-3709
Practice Address - Country:US
Practice Address - Phone:248-894-0627
Practice Address - Fax:248-289-6817
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010689731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical