Provider Demographics
NPI:1710232756
Name:SRISKAND, MARLA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MARLA
Middle Name:
Last Name:SRISKAND
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 1:12700 NW 8TH CT
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-4409
Mailing Address - Country:US
Mailing Address - Phone:954-632-1203
Mailing Address - Fax:
Practice Address - Street 1:950 N FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062-4315
Practice Address - Country:US
Practice Address - Phone:954-533-7705
Practice Address - Fax:954-781-7191
Is Sole Proprietor?:No
Enumeration Date:2012-07-16
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 88031041C0700X
FLSW8803101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical