Provider Demographics
NPI:1235656638
Name:FLORO, MARISA (LCSW)
Entity Type:Individual
Prefix:
First Name:MARISA
Middle Name:
Last Name:FLORO
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 1:3607 BUTLER ST APT 201
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15201-1871
Mailing Address - Country:US
Mailing Address - Phone:412-847-5169
Mailing Address - Fax:
Practice Address - Street 1:540 N NEVILLE ST STE 102
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-2853
Practice Address - Country:US
Practice Address - Phone:412-847-5169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-25
Last Update Date:2020-05-05
Deactivation Date:2019-12-17
Deactivation Code:
Reactivation Date:2019-12-31
Provider Licenses
StateLicense IDTaxonomies
PACW0202991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical