Provider Demographics
NPI:1043801350
Name:MARELIN DOST LICSW LLC
Entity Type:Organization
Organization Name:MARELIN DOST LICSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LLC SINGLE MEMBER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARELIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DOST
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:508-301-3590
Mailing Address - Street 1:859 WILLARD ST STE 400
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-7469
Mailing Address - Country:US
Mailing Address - Phone:508-301-3590
Mailing Address - Fax:508-301-1890
Practice Address - Street 1:859 WILLARD ST STE 400
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-7469
Practice Address - Country:US
Practice Address - Phone:508-301-3590
Practice Address - Fax:508-301-1890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-29
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty