Provider Demographics
NPI:1467759191
Name:MARCUS, ANALINDA
Entity Type:Individual
Prefix:
First Name:ANALINDA
Middle Name:
Last Name:MARCUS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANALINDA
Other - Middle Name:
Other - Last Name:MARCUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16 BOWDOIN AVE #2
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02121
Mailing Address - Country:US
Mailing Address - Phone:617-512-0430
Mailing Address - Fax:
Practice Address - Street 1:16 BOWDOIN AVE FL 2
Practice Address - Street 2:
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02121-3902
Practice Address - Country:US
Practice Address - Phone:617-512-0430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-15
Last Update Date:2016-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1557106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist