Provider Demographics
NPI:1578887204
Name:ADORABLE, MARIE (ASW # 102595)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:ADORABLE
Suffix:
Gender:F
Credentials:ASW # 102595
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1510 FASHION ISLAND BLVD STE 310
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94404-1587
Mailing Address - Country:US
Mailing Address - Phone:415-265-7201
Mailing Address - Fax:
Practice Address - Street 1:1510 FASHION ISLAND BLVD STE 310
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94404-1587
Practice Address - Country:US
Practice Address - Phone:415-265-7201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-24
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
CA1025951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor