Provider Demographics
NPI:1194205005
Name:RESNICK, MARCY S (LCSW)
Entity Type:Individual
Prefix:
First Name:MARCY
Middle Name:S
Last Name:RESNICK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 BANCROFT MILLS RD APT P3
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19806-2031
Mailing Address - Country:US
Mailing Address - Phone:302-530-2535
Mailing Address - Fax:
Practice Address - Street 1:507 PHILADELPHIA PIKE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19809-2177
Practice Address - Country:US
Practice Address - Phone:302-762-8989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-20
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00014361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEQ1-0001436OtherDIVISION OF PROFESSIONAL REGULATION LCSW