Provider Demographics
NPI:1407633258
Name:MYERS, MARIANNE (LSW)
Entity Type:Individual
Prefix:
First Name:MARIANNE
Middle Name:
Last Name:MYERS
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 WESCOTT RD
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-3455
Mailing Address - Country:US
Mailing Address - Phone:908-421-9658
Mailing Address - Fax:
Practice Address - Street 1:220 WESCOTT RD
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-3455
Practice Address - Country:US
Practice Address - Phone:908-421-9658
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-13
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06815700104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker