Provider Demographics
NPI:1376027474
Name:MARENTAY, LLC
Entity Type:Organization
Organization Name:MARENTAY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:COSNER-MARENTAY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:724-473-9444
Mailing Address - Street 1:1158 PITTSBURGH RD STE 200
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:PA
Mailing Address - Zip Code:16059-3128
Mailing Address - Country:US
Mailing Address - Phone:724-473-9444
Mailing Address - Fax:
Practice Address - Street 1:1158 PITTSBURGH RD STE 200
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:PA
Practice Address - Zip Code:16059-3128
Practice Address - Country:US
Practice Address - Phone:724-473-9444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MARENTAY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-09-24
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1770764581Medicaid