Provider Demographics
NPI:1851509483
Name:ISAKSEN, MARIT ANN (MA, LMHC)
Entity Type:Individual
Prefix:MS
First Name:MARIT
Middle Name:ANN
Last Name:ISAKSEN
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:MS
Other - First Name:MARIT
Other - Middle Name:ANN
Other - Last Name:ISAKSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:345 UNION ST
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02740-3679
Mailing Address - Country:US
Mailing Address - Phone:774-202-6502
Mailing Address - Fax:774-202-2826
Practice Address - Street 1:345 UNION ST
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740
Practice Address - Country:US
Practice Address - Phone:774-202-6502
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2018-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA136879163W00000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No163W00000XNursing Service ProvidersRegistered Nurse