Provider Demographics
NPI:1225411853
Name:MARINO, CESIA ENEIDA (LIMHP)
Entity Type:Individual
Prefix:
First Name:CESIA
Middle Name:ENEIDA
Last Name:MARINO
Suffix:
Gender:F
Credentials:LIMHP
Other - Prefix:
Other - First Name:CESIA
Other - Middle Name:E
Other - Last Name:ROCHE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PLMHP
Mailing Address - Street 1:207 GALVIN RD N
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68005-4898
Mailing Address - Country:US
Mailing Address - Phone:402-300-8169
Mailing Address - Fax:402-300-8169
Practice Address - Street 1:207 GALVIN RD N
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68005-4898
Practice Address - Country:US
Practice Address - Phone:402-300-8169
Practice Address - Fax:402-300-8169
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-01
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE10551101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health