Provider Demographics
NPI:1346026739
Name:JEFFREY MARCHESE LCSW
Entity Type:Organization
Organization Name:JEFFREY MARCHESE LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MBR
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:MARCHESE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:484-661-6158
Mailing Address - Street 1:502 W 7TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16502-1333
Mailing Address - Country:US
Mailing Address - Phone:484-661-6158
Mailing Address - Fax:
Practice Address - Street 1:502 W 7TH ST STE 100
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16502-1333
Practice Address - Country:US
Practice Address - Phone:484-661-6158
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-01
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty