Provider Demographics
NPI:1518174119
Name:MARSON, JAY DAVID (MSW)
Entity Type:Individual
Prefix:
First Name:JAY
Middle Name:DAVID
Last Name:MARSON
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 WESTCHESTER AVENUE
Mailing Address - Street 2:SUITE 406
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10604
Mailing Address - Country:US
Mailing Address - Phone:914-946-4666
Mailing Address - Fax:914-946-4003
Practice Address - Street 1:222 WESTCHESTER AVENUE
Practice Address - Street 2:SUITE 406
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10604
Practice Address - Country:US
Practice Address - Phone:914-946-4666
Practice Address - Fax:914-946-4003
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035162104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker