Provider Demographics
NPI:1619256252
Name:MARROQUIN, BELVETH B (LCSW # 110655)
Entity Type:Individual
Prefix:MS
First Name:BELVETH
Middle Name:B
Last Name:MARROQUIN
Suffix:
Gender:F
Credentials:LCSW # 110655
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1533 EUCLID ST
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-3306
Mailing Address - Country:US
Mailing Address - Phone:310-451-9747
Mailing Address - Fax:
Practice Address - Street 1:1533 EUCLID ST
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-3306
Practice Address - Country:US
Practice Address - Phone:310-451-9747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-14
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW # 30817101YM0800X
CA1106551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health