Provider Demographics
NPI:1326133570
Name:OSSE, MARILYN FAYE (LCSW-PIP)
Entity Type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:FAYE
Last Name:OSSE
Suffix:
Gender:F
Credentials:LCSW-PIP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 N HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:PIERRE
Mailing Address - State:SD
Mailing Address - Zip Code:57501-2378
Mailing Address - Country:US
Mailing Address - Phone:605-945-1710
Mailing Address - Fax:
Practice Address - Street 1:1601 N HARRISON AVE
Practice Address - Street 2:
Practice Address - City:PIERRE
Practice Address - State:SD
Practice Address - Zip Code:57501-2378
Practice Address - Country:US
Practice Address - Phone:605-945-1710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2015-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD14221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical