Provider Demographics
NPI:1639373822
Name:PORTNOY, MARSHA (LCSW)
Entity Type:Individual
Prefix:
First Name:MARSHA
Middle Name:
Last Name:PORTNOY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 FRANKLIN CORNER RD
Mailing Address - Street 2:PSYCHOTHERAPY AT THE ATRIUM
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-2531
Mailing Address - Country:US
Mailing Address - Phone:609-240-3126
Mailing Address - Fax:
Practice Address - Street 1:133 FRANKLIN CORNER RD
Practice Address - Street 2:PSYCHOTHERAPY AT THE ATRIUM
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-2531
Practice Address - Country:US
Practice Address - Phone:609-240-3126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-12
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC053788001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical