Provider Demographics
NPI:1689862294
Name:MARSK, ANGELA GRACE (LCSW)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:GRACE
Last Name:MARSK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:GRACE
Other - Last Name:LESLIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSWA
Mailing Address - Street 1:205 S KINGS DR STE 150
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204-2661
Mailing Address - Country:US
Mailing Address - Phone:980-375-7550
Mailing Address - Fax:
Practice Address - Street 1:205 S KINGS DR STE 150
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-2661
Practice Address - Country:US
Practice Address - Phone:980-375-7550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical