Provider Demographics
NPI:1740747039
Name:MARQUIS, ADRIENNE (LCSW)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:
Last Name:MARQUIS
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 1:264 OLD PERUVILLE RD
Mailing Address - Street 2:
Mailing Address - City:GROTON
Mailing Address - State:NY
Mailing Address - Zip Code:13073-8733
Mailing Address - Country:US
Mailing Address - Phone:607-423-0886
Mailing Address - Fax:
Practice Address - Street 1:264 OLD PERUVILLE RD
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:NY
Practice Address - Zip Code:13073-8733
Practice Address - Country:US
Practice Address - Phone:607-423-0886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-23
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker