Provider Demographics
NPI:1467581181
Name:PIERCE, MARJORIE ANN (LICSW)
Entity Type:Individual
Prefix:MS
First Name:MARJORIE
Middle Name:ANN
Last Name:PIERCE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 GREEN ST
Mailing Address - Street 2:THE CARRIAGE HOUSE
Mailing Address - City:NEWBURYPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01950-2650
Mailing Address - Country:US
Mailing Address - Phone:978-465-1234
Mailing Address - Fax:978-465-7301
Practice Address - Street 1:28 GREEN ST
Practice Address - Street 2:THE CARRIAGE HOUSE
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950-2650
Practice Address - Country:US
Practice Address - Phone:978-465-1234
Practice Address - Fax:978-465-7301
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1111171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical