| Doctor Name: | MR. RICHARD MATTHEW MARVELL |
| NPI Number: | 1215111919 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LPC |
| License Number: | 3142 |
| Business Practice Address: | 200 Elkin Business Park Dr Elkin, NC - 286213159 |
| Business Phone Number: | 3368351000 |
| Business Fax Number: | 3368356808 |
| Mailing Address: | 200 Elkin Business Park Dr, ELKIN |
| State: | NC |
| Postal Code: | 286213159 |
| Phone Number: | 3368351000 |
| Fax Number: | 3368356808 |
| NPI Enumeration Date: | 12/18/2007 |
| NPI Last Update Date: | 12/18/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC1900X |
| License Number: | 3142 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Counseling |
| Taxonomy Definition: | |