Provider Demographics
NPI:1609913656
Name:PRITIKIN, MARILYN TURCK (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:MARILYN
Middle Name:TURCK
Last Name:PRITIKIN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 CAMBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02141-1204
Mailing Address - Country:US
Mailing Address - Phone:617-547-0909
Mailing Address - Fax:617-497-5952
Practice Address - Street 1:350 CAMBRIDGE ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02141-1204
Practice Address - Country:US
Practice Address - Phone:617-547-0909
Practice Address - Fax:617-497-5952
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1240106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA468674OtherTUFTS
MA5681-04OtherPACIFICARE