Provider Demographics
NPI:1093413627
Name:DIANE MARASCIA LCSW PC
Entity Type:Organization
Organization Name:DIANE MARASCIA LCSW PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARASCIA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:631-513-1418
Mailing Address - Street 1:108 COLONY DR
Mailing Address - Street 2:
Mailing Address - City:HOLBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11741-2839
Mailing Address - Country:US
Mailing Address - Phone:631-513-1418
Mailing Address - Fax:
Practice Address - Street 1:859 MONTAUK HWY STE 2
Practice Address - Street 2:
Practice Address - City:BAYPORT
Practice Address - State:NY
Practice Address - Zip Code:11705-1634
Practice Address - Country:US
Practice Address - Phone:631-513-1418
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-22
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty