Provider Demographics
NPI:1568072254
Name:SPIESS, MARIAN MARGARET (MA, LADC)
Entity Type:Individual
Prefix:MISS
First Name:MARIAN
Middle Name:MARGARET
Last Name:SPIESS
Suffix:
Gender:F
Credentials:MA, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 1ST AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-3401
Mailing Address - Country:US
Mailing Address - Phone:612-235-7335
Mailing Address - Fax:
Practice Address - Street 1:2200 1ST AVE S
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-3401
Practice Address - Country:US
Practice Address - Phone:612-235-7335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-06
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN305114101YA0400X
MNCC02574101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)